Healthcare Provider Details

I. General information

NPI: 1013028422
Provider Name (Legal Business Name): HEATHER L PREUSS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER L PREUSS MD

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 HIGHWAY 71 S STE 101
HOT SPRINGS SD
57747-8801
US

IV. Provider business mailing address

353 FAIRMONT BLVD ATTN MSS
RAPID CITY SD
57701-7350
US

V. Phone/Fax

Practice location:
  • Phone: 605-745-5188
  • Fax: 605-745-3039
Mailing address:
  • Phone: 605-755-8107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7492
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: