Healthcare Provider Details

I. General information

NPI: 1528407616
Provider Name (Legal Business Name): REGIONAL HEALTH PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2013
Last Update Date: 06/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 N 10TH ST
SPEARFISH SD
57783-1532
US

IV. Provider business mailing address

PO BOX 9263
BELFAST ME
04915-9263
US

V. Phone/Fax

Practice location:
  • Phone: 605-642-8414
  • Fax:
Mailing address:
  • Phone: 605-642-8414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number214518
License Number StateSD

VIII. Authorized Official

Name: JOHN Y PIERCE
Title or Position: COO/RHP
Credential:
Phone: 605-755-9042