Avera Mckennan in Volga - Physician Assistant
Avera Mckennan - NPI 1063432573
Avera Mckennan is a Physician Assistant in Volga, South Dakota. Avera Mckennan practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Avera Mckennan is 1063432573. The last update date is 2011-03-11.
Avera Mckennan's current location address is 210 Kasan Ave, Volga, South Dakota. You can contact this provider via phone number 6056275701 and fax number 6056275990. The mailing address for Avera Mckennan is 210 Kasan Ave, Volga, South Dakota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Avera Mckennan |
|---|---|
| Address | 210 Kasan Ave, Volga, South Dakota |
| Phone Number | 6056275701 |
| Fax Number | 6056275990 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CFO |
|---|---|
| Authorized Official Name | Norton N. Julie |
| Telephone Number | 6053226375 |
NPI Number Detail
| NPI Number | 1063432573 |
|---|---|
| Provider Enumeration Date | 2006-07-20 |
| Last Updated Date | 2011-03-11 |
Provider Mailing Address Detail
| Address | 210 Kasan Ave |
|---|---|
| City | Volga |
| State | South Dakota (SD) |
| Post Code | 57071 |
| Phone Number | 6056275701 |
| Fax Number | 6056275990 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 84 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7300750 | SD | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Avera Mckennan by the Centers for Medicare & Medicaid Services?
The Avera Mckennan has been assigned the NPI (National Provider Identifier) 1063432573 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Can you provide the Avera Mckennan's physical address?
The Avera Mckennan is physically located at 210 Kasan Ave, in the city of Volga, SD, with the postal code 57071.
What is the Avera Mckennan's area of specialization and corresponding taxonomy classification?
The Avera Mckennan's specialty field is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services assign the 1063432573 to Avera Mckennan?
The Centers for Medicare & Medicaid Services assigned the 1063432573 to Avera Mckennan on 2006-07-20.
As of what date were the Avera Mckennan's details last updated?
The information pertaining to the Avera Mckennan, including its address, specialty, and other details, was most recently updated on 2011-03-11.