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NPI Code Detail

MEDICARE: KIM W JUNDT MD

MEDICARE: KIM W JUNDT MD
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
1207Q00000XFamily Medicine Physician4194SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801890652
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM W JUNDT MD
Provider Business Mailing Address
First Line : 1200 S 7TH AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57105-0900
Country : US
Telephone Number : 605-504-5400
Fax Number : 605-504-5150
Provider Business Practice Location Address
First Line : 2100 S MARION RD
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57106-3646
Country : US
Telephone Number : 605-322-5180
Fax Number : 605-322-5179
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 04/18/2022

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