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General NPI Number Information
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NPI Number | 1396945267
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Entity Type | Organization
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Legal Business Name | AVERA MCKENNAN
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 1600 S HIGHLINE AVE STE 220
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City | SIOUX FALLS
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State | SD
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Zip | 57110-1008
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Country | US
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Telephone | 605-322-8535
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Fax | 605-322-8536
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Provider Business Mailing Address
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Address Line | PO BOX 86370
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City | SIOUX FALLS
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State | SD
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Zip | 57118-6370
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Country | US
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Telephone | 605-322-7510
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Fax | 605-322-6475
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | RONALD PLACE
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Credential |
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Telephone | 605-322-7903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0008X
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Taxonomy Name | Hepatology Physician
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License Number |
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License Number State |
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