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General NPI Number Information
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NPI Number | 1902827918
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Entity Type | Individual
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Provider Name | DANNY D RICKARD PA
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Gender | Male
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 05/31/2011
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Provider Practice Location Address
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Address Line | 401 9TH AVE NW
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City | WATERTOWN
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State | SD
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Zip | 57201-1548
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Country | US
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Telephone | 605-882-2630
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Fax | 605-882-0447
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Provider Business Mailing Address
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Address Line | PO BOX 170
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City | WATERTOWN
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State | SD
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Zip | 57201-0170
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Country | US
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Telephone | 605-882-2630
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Fax | 605-882-0447
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 0555
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License Number State | SD
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