Healthcare Provider Details

I. General information

NPI: 1831353242
Provider Name (Legal Business Name): RECONSTRUCTIVE SPINAL SURGERY & ORTHOPEDIC SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2007 LOCUST ST
YANKTON SD
57078-2030
US

IV. Provider business mailing address

109 N 29TH ST
NORFOLK NE
68701-3261
US

V. Phone/Fax

Practice location:
  • Phone: 605-689-6890
  • Fax:
Mailing address:
  • Phone: 402-371-0839
  • Fax: 402-371-0840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALLEN A SOSSAN
Title or Position: OWNER AND PROVIDER
Credential: DO
Phone: 402-371-0839