Healthcare Provider Details

I. General information

NPI: 1083763288
Provider Name (Legal Business Name): K ALAN KELTS MD STEVEN K HATA MD ROBERT C FINLEY MD ETAL PTRS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 5TH ST STE 240
RAPID CITY SD
57701-7363
US

IV. Provider business mailing address

2929 5TH ST STE 240
RAPID CITY SD
57701-7363
US

V. Phone/Fax

Practice location:
  • Phone: 605-341-3770
  • Fax: 605-341-8692
Mailing address:
  • Phone: 605-341-3770
  • Fax: 605-341-8692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JEANINE LEWIS
Title or Position: PATIENT ACCOUNTS
Credential:
Phone: 605-341-3770