Healthcare Provider Details

I. General information

NPI: 1801212402
Provider Name (Legal Business Name): REGIONAL HEALTH PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2014
Last Update Date: 08/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 7TH AVENUE
WALL SD
57790
US

IV. Provider business mailing address

PO BOX 9263
BELFAST ME
04915-9263
US

V. Phone/Fax

Practice location:
  • Phone: 605-279-2149
  • Fax: 605-279-2139
Mailing address:
  • Phone: 605-755-7649
  • Fax: 605-755-7884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN Y PIERCE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 605-755-9142