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NPI Code Detail

MEDICARE: CLIFFORD A MCNAUGHTON M.D., DDS

MEDICARE:   CLIFFORD A MCNAUGHTON  M.D., DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician4757SD

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12P00302185OTHERSDRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1412991046307OTHERSDPREFERRED ONE
252454OTHERSDSANFORD HEALTH PLAN
357108C031OTHERSDWPS TRICARE
4040121002OTHERMNPRIMEWEST
5HP59561OTHERSDHEALTHPARTNERS
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7244132OTHERSDMIDLANDS CHOICE
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
94757OTHERSDDAKOTACARE
104994129OTHERSDBLUE CROSS
11MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13370624200OTHERSDDEPT OF LABOR
1495G48MCOTHERMNCC SYSTEMS/ BLUE PLUS
15MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16770534OTHERSDARAZ/ AMERICA'S PPO

General Provider Information

NPI Number : 1184697633
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLIFFORD A MCNAUGHTON M.D., DDS
Provider Business Mailing Address
First Line : PO BOX 86370
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57118-6370
Country : US
Telephone Number : 605-322-7510
Fax Number : 605-322-6475
Provider Business Practice Location Address
First Line : 4400 W 69TH ST
Second Line : STE 1500
City : SIOUX FALLS
State : SD
Zip : 57108-8170
Country : US
Telephone Number : 605-322-5700
Fax Number : 605-322-5704
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 12/19/2008

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Directions to “ CLIFFORD A MCNAUGHTON M.D., DDS” Practice Location

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