Healthcare Provider Details

I. General information

NPI: 1811043102
Provider Name (Legal Business Name): JOE KRALL O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 N SANBORN BLVD
MITCHELL SD
57301-1015
US

IV. Provider business mailing address

1415 N SANBORN BLVD
MITCHELL SD
57301-1015
US

V. Phone/Fax

Practice location:
  • Phone: 605-996-2020
  • Fax: 605-990-3937
Mailing address:
  • Phone: 605-996-2020
  • Fax: 605-990-3937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number494
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number494
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier9202632
Identifier TypeMEDICAID
Identifier StateSD
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: