Healthcare Provider Details

I. General information

NPI: 1609044270
Provider Name (Legal Business Name): LOIS I TRUH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 DAKOTA AVE S
HURON SD
57350-2726
US

IV. Provider business mailing address

807 DAKOTA AVE S
HURON SD
57350-2726
US

V. Phone/Fax

Practice location:
  • Phone: 605-352-7070
  • Fax:
Mailing address:
  • Phone: 605-352-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3465
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number3465
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: