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General NPI Number Information
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NPI Number | 1255645693
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Entity Type | Organization
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Legal Business Name | SANFORD HEALTH NETWORK
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Dates
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Enumeration Date | 07/27/2010
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Last Update Date | 07/27/2010
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Provider Practice Location Address
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Address Line | 317 BROADWAY AVE STE 8
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City | YANKTON
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State | SD
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Zip | 57078-4258
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Country | US
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Telephone | 605-665-8838
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Fax | 605-665-1123
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Provider Business Mailing Address
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Address Line | 317 BROADWAY AVE STE 8
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City | YANKTON
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State | SD
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Zip | 57078-4258
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | BRUCE VIESSMAN
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Credential |
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Telephone | 605-328-5506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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