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General NPI Number Information
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NPI Number | 1609817584
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Entity Type | Organization
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Legal Business Name | YANKTON BONE JOINT & SPORTS MEDICINE CENTER PC
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 06/16/2011
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Provider Practice Location Address
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Address Line | 1000 W 4TH ST SUITE 1
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City | YANKTON
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State | SD
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Zip | 57078-3730
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Country | US
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Telephone | 605-668-8780
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 W 4TH ST SUITE 1
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City | YANKTON
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State | SD
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Zip | 57078-3700
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Country | US
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Telephone | 605-668-8780
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Fax | 605-668-9192
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL C. JOHNSON
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Credential | M.D.
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Telephone | 605-668-8780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 0301
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License Number State | SD
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