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NPI Code Detail

MEDICARE: YANKTON MEDICAL CLINIC PC

MEDICARE: YANKTON MEDICAL CLINIC PC
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
1208D00000XGeneral Practice PhysicianSD

General Provider Information

NPI Number : 1306962162
Entity Type Code : Organization
Provider Name (Legal Business Name) : YANKTON MEDICAL CLINIC PC
Provider Business Mailing Address
First Line : 101 S PLUM ST
Second Line :
City : VERMILLION
State : SD
Zip : 57069-3306
Country : US
Telephone Number : 605-624-8643
Fax Number :
Provider Business Practice Location Address
First Line : 101 S PLUM ST
Second Line :
City : VERMILLION
State : SD
Zip : 57069-3306
Country : US
Telephone Number : 605-624-8643
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : CHARLES A AMAN
Credential :
Telephone Number : 605-665-7841
Provider Enumeration Date : 03/22/2007
Last Update Date : 06/19/2008

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Directions to “YANKTON MEDICAL CLINIC PC ” Practice Location

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