Healthcare Provider Details

I. General information

NPI: 1871581876
Provider Name (Legal Business Name): OPHTHALMOLOGY LTD EYE SURGERY CENTER L L C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 05/02/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 S. MINNESOTA AVENUE SUITE 100
SIOUX FALLS SD
57108-2564
US

IV. Provider business mailing address

6601 S. MINNESOTA AVENUE SUITE 100
SIOUX FALLS SD
57108-2564
US

V. Phone/Fax

Practice location:
  • Phone: 605-336-6294
  • Fax: 605-336-2672
Mailing address:
  • Phone: 605-336-6294
  • Fax: 605-336-2672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number41051
License Number StateSD

VIII. Authorized Official

Name: KATHY NORD
Title or Position: OFFICE MANAGER
Credential:
Phone: 605-731-2630