Healthcare Provider Details

I. General information

NPI: 1497713424
Provider Name (Legal Business Name): HEARTLAND ORTHOPEDIC CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1727 S CLEVELAND AVE
SIOUX FALLS SD
57103-3245
US

IV. Provider business mailing address

1727 S CLEVELAND AVE
SIOUX FALLS SD
57103-3245
US

V. Phone/Fax

Practice location:
  • Phone: 605-333-0400
  • Fax: 605-333-4875
Mailing address:
  • Phone: 605-333-0400
  • Fax: 605-333-4875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number StateSD

VIII. Authorized Official

Name: DR. DANIEL G MACRANDALL
Title or Position: PRESIDENT
Credential: MD
Phone: 605-333-0400