Healthcare Provider Details

I. General information

NPI: 1548288863
Provider Name (Legal Business Name): BENJAMIN JAMES MCKINLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4520 W 69TH ST
SIOUX FALLS SD
57108-8148
US

IV. Provider business mailing address

4520 W 69TH ST
SIOUX FALLS SD
57108-8148
US

V. Phone/Fax

Practice location:
  • Phone: 605-977-5000
  • Fax: 605-977-5377
Mailing address:
  • Phone: 605-977-5000
  • Fax: 605-977-5377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number18605
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number48176
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: