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PRAIRIE DERMATOLOGY PC NPI 1164622098


NPI Information

NPI: 1164622098
Provider Name: PRAIRIE DERMATOLOGY PC
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
201 S LLOYD ST
SUITE E206
ABERDEEN, SD
ZIP 57401
Phone: (605) 226-0560
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PRAIRIE DERMATOLOGY PC is a medical specialty clinic center in Aberdeen, SD. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). PRAIRIE DERMATOLOGY PC NPI is 1164622098. The provider is registered as an organization entity type.

The provider's business location address is:

201 S LLOYD ST
SUITE E206
ABERDEEN, SD
ZIP 57401-552
Phone: (605) 226-0560

The provider's authorized official is Ty Hanson .
The authorized official title is Dermatologist and has the following contact phone number (605) 226-0560.

The enumeration date for this NPI number is 7/19/2007 and was last updated on 7/19/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical Specialty7021SOUTH DAKOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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