Healthcare Provider Details

I. General information

NPI: 1184242612
Provider Name (Legal Business Name): TURNER DAVID SERR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2020
Last Update Date: 07/10/2020
Certification Date: 07/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5808 W OAKCREST DR
SIOUX FALLS SD
57107-0997
US

IV. Provider business mailing address

5808 W OAKCREST DR
SIOUX FALLS SD
57107-0997
US

V. Phone/Fax

Practice location:
  • Phone: 605-830-0145
  • Fax:
Mailing address:
  • Phone: 605-830-0145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier2000038730
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerCERTIFICATION NUMBER

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: