Healthcare Provider Details

I. General information

NPI: 1104025113
Provider Name (Legal Business Name): JONI BUECHLER-PRICE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 9TH AVE NW
WATERTOWN SD
57201-1548
US

IV. Provider business mailing address

PO BOX 1210
WATERTOWN SD
57201-6210
US

V. Phone/Fax

Practice location:
  • Phone: 605-882-7000
  • Fax: 605-882-6835
Mailing address:
  • Phone: 605-882-7917
  • Fax: 605-882-7636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberR8093
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number12680
License Number StateND
# 3
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number9059
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: