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Avera McKennan

Organization Active NPI Pediatric Critical Care Medicine Physician · Sioux Falls, SD

NPI 1821686932 · NPPES record last updated Jan 5, 2021

Key facts

NPI
1821686932
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Critical Care Medicine Physician 2080P0203X
Legal business name
AVERA MCKENNAN
Practice address
1417 S Cliff Ave Ste 201
Sioux Falls, SD 57105-1009
Phone
(605) 322-3440
Fax
(605) 322-3654
NPI assigned
Jan 5, 2021
Organization subpart
No

Authorized official

Name
David William Flicek
Title
President/Ceo
Phone
(605) 322-7915

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Avera McKennan Hosp (105 organizations share this tax ID)

Locations

1417 S Cliff Ave
Ste 201
Sioux Falls, SD 57105
Phone (605) 322-3440

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 2080P0203X Yes

Addresses

Primary practice location

1417 S Cliff Ave Ste 201
Sioux Falls, SD 57105-1009

Mailing address

PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-6408

Other names

  • Avera Medical Group Pediatric Critical Care Services Doing business as

Other providers in Sioux Falls, SD

All providers in Sioux Falls, SD · Pediatric Critical Care Medicine Physician in South Dakota

Sources for this page

Verify at the official NPI Registry.