Healthcare Provider Details
I. General information
NPI: 1780099135
Provider Name (Legal Business Name): JAMES RONALD HEGVIK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/24/2014
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
575 N SIOUX POINT ROAD
DAKOTA DUNES SD
57049-5312
US
IV. Provider business mailing address
575 N SIOUX POINT ROAD
DAKOTA DUNES SD
57049-5312
US
V. Phone/Fax
- Phone: 605-217-2667
- Fax: 605-217-2900
- Phone: 605-217-2667
- Fax: 605-217-2900
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | R-10078 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | MD-45898 |
| License Number State | IA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 31594 |
| License Number State | NE |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 11590 |
| License Number State | SD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: