Healthcare Provider Details

I. General information

NPI: 1528035524
Provider Name (Legal Business Name): SANDRA KAY ROOKS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HIGHWAY 18 PHS INDIAN HOSPITAL
PINE RIDGE SD
57770
US

IV. Provider business mailing address

HC 52 BOX 177D
HOT SPRINGS SD
57747-9609
US

V. Phone/Fax

Practice location:
  • Phone: 605-867-3171
  • Fax:
Mailing address:
  • Phone: 605-745-5722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number3771
License Number StateSD

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: