Healthcare Provider Details

I. General information

NPI: 1184608622
Provider Name (Legal Business Name): RONOLD R TESCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 07/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 YORKSHIRE DRIVE SUITE C
BROOKINGS SD
57006-2446
US

IV. Provider business mailing address

2311 YORKSHIRE DRIVE SUITE C YORKSHIRE EYE CLINIC
BROOKINGS SD
57006-2446
US

V. Phone/Fax

Practice location:
  • Phone: 605-692-7315
  • Fax: 605-692-2615
Mailing address:
  • Phone: 605-692-7315
  • Fax: 605-692-2615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2023
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: