MEDICARE: BRIAN DENNIS KNUTSON M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	4732	SD

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	070016845	OTHER	SD	RR MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	27020	OTHER	SD	SANFORD HEALTH PLAN
2	35306	OTHER	SD	MIDLANDS CHOICE
3	9171639	OTHER	SD	DAKOTACARE
4	0040220	OTHER	SD	BLUE CROSS
5	1066411	OTHER	SD	ARAZ/ AMERICA'S PPO
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	57108B003	OTHER	SD	WPS TRICARE
10	HP37119	OTHER	SD	HEALTHPARTNERS
11	397A1KN	OTHER	MN	CC SYSTEMS/ BLUE PLUS
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	0300192	OTHER	SD	MEDICA
15	397A1KN & 640S0KN	OTHER	MN	BLUE CROSS
16	407211028110	OTHER	SD	PREFERRED ONE

NPI Number	:	1720054539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN DENNIS KNUTSON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 86370
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57118-6370
Country	:	US
Telephone Number	:	605-322-7510
Fax Number	:	605-322-6475

Provider Business Practice Location Address
First Line	:	6701 S MINNESOTA AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2591
Country	:	US
Telephone Number	:	605-322-6960
Fax Number	:	605-322-6961

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	10/15/2018

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

6701 S MINNESOTA AVE
SIOUX FALLS, SD
57108-2591