Healthcare Provider Details

I. General information

NPI: 1952325227
Provider Name (Legal Business Name): SLINGSBY & WRIGHT EYE SURGERY & LASER CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 MINNESOTA ST
RAPID CITY SD
57701-6200
US

IV. Provider business mailing address

240 MINNESOTA ST
RAPID CITY SD
57701-6200
US

V. Phone/Fax

Practice location:
  • Phone: 605-718-5123
  • Fax: 605-719-9509
Mailing address:
  • Phone: 605-718-5123
  • Fax: 605-719-9509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number11142
License Number StateSD

VII. Legacy identifiers

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

# 1
Identifier5490310
Identifier TypeMEDICAID
Identifier StateSD
Identifier Issuer

VIII. Authorized Official

Name: PAUL LOUIS WRIGHT
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 605-718-5123