David Dean Stimpson, RT
Individual provider Active NPI Radiologic Technologist · Wagner, SD
NPI 1295940385 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1295940385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Radiologic Technologist 247100000X
- License
- 384415 (SD)
- Practice address
- 111 Washington Ave NW
Wagner, SD 57380 - Phone
- (605) 384-3621
- Fax
- (605) 384-3293
- NPI assigned
- May 11, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 384415 | SD | MD | Radiologic Technologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | 384415 | SD | Yes |
Addresses
Primary practice location
111 Washington Ave NW
Wagner, SD 57380
Mailing address
111 Washington Ave NW
Wagner, SD 57380
Phone (605) 384-3621
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5540030 | Medicaid | SD | |
| 5540100 | Medicaid | SD |
Other providers in Wagner, SD
- Joseph R Sees
- Sioux Falls Vamc
- Tianna Rose Smith
- Jazmyn Soukup
- Carol Lee Stewart
- Mark Struble
- Timothy Darien Thaler
- Tori Sarah Thaler
- Vicki Lynn Thaler
- The Evangelical Lutheran Good Samaritan Society
All providers in Wagner, SD · Radiologic Technologist in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.