MEDICARE: HEARTLAND ORTHOPEDIC CLINIC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center		SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	117042	OTHER	UCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497713424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTLAND ORTHOPEDIC CLINIC PC

Provider Business Mailing Address
First Line	:	1727 S CLEVELAND AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57103-3245
Country	:	US
Telephone Number	:	605-333-0400
Fax Number	:	605-333-4875

Provider Business Practice Location Address
First Line	:	1727 S CLEVELAND AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57103-3245
Country	:	US
Telephone Number	:	605-333-0400
Fax Number	:	605-333-4875

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DANIEL G MACRANDALL
Credential	:	MD
Telephone Number	:	605-333-0400

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	03/29/2010

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Directions to “HEARTLAND ORTHOPEDIC CLINIC PC ” Practice Location

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