Avera Mckennan, NPI 1346216074
Dermatology Physician in Sioux Falls, SD, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1346216074
NPI Entity Type Organization
Provider Name Avera Mckennan
Doing Business As
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Certification Date September 30, 2009
Provider Location Address 6701 S Minnesota Ave, Sioux Falls, SD, US
Provider Mailing Address Po Box 86370, Sioux Falls, SD, US, 571186370
Gender Male
Is Sole Proprietor? No
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Organization Official

Official Name David Flicek
Official Position CEO/PRESIDENT
Phone 605-322-8000

Group Taxonomy

Taxonomy Code 193400000X
Taxonomy Name 193400000X SINGLE SPECIALTY GROUP
Definition A business group of one or more individual practitioners, all of who practice with the same area of specialization.

Primary Taxonomy

Taxonomy Code

207N00000X

Taxonomy Name Dermatology Physician
Classification

Dermatology

Group

Allopathic & Osteopathic Physicians

Description A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Other Organization Name

Avera Medical Group Dermatology Sioux Falls
Doing Business As

Business Address

Avera Mckennan
6701 S Minnesota Ave

Sioux Falls, SD, US

Phone: 605-322-6960
Fax: 605-322-6961

Mailing Address

Avera Mckennan
Po Box 86370
Sioux Falls, SD, US
ZIP 571186370
Phone: 605-322-7510
Fax: 605-322-6475

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
115182700 MN MEDICAID 05
370624200 SD DEPT OF LABOR 01
396S9MI MN BLUE PLUS 01
9202239 SD DAKOTACARE 01
040122003 MN PRIMEWEST 01
83986 SD HEALTHPARTNERS 01
0554733 IA MEDICAID 05
0040219 SD BCBS 01
396S9MI MN BCBS 01

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