Healthcare Provider Details
I. General information
NPI: 1700090560
Provider Name (Legal Business Name): REGIONAL HEALTH PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/10/2007
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 EAST THIRD STREET
NEWELL SD
57760-0468
US
IV. Provider business mailing address
1445 NORTH AVENUE
SPEARFISH SD
57783-1552
US
V. Phone/Fax
- Phone: 605-456-2462
- Fax: 605-456-1001
- Phone: 605-644-4170
- Fax: 605-644-4198
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
Y
PIERCE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 605-719-8394