Healthcare Provider Details

I. General information

NPI: 1164288304
Provider Name (Legal Business Name): THVC SERVICES OF SD, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S REID ST STE 307
SIOUX FALLS SD
57103-7045
US

IV. Provider business mailing address

265 BROOKVIEW CENTRE WAY STE. 203
KNOXVILLE TN
37919-4052
US

V. Phone/Fax

Practice location:
  • Phone: 865-693-1000
  • Fax:
Mailing address:
  • Phone: 865-693-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH THOMPSON CRANE IV
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 865-693-1000