1508054057 NPI number — WILLIAM SAUNDERS D C P C

Table of content: (NPI 1508054057)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508054057 NPI number — WILLIAM SAUNDERS D C P C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM SAUNDERS D C P C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508054057
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
717 E MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VERMILLION
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57069-3312
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-624-8822
Provider Business Mailing Address Fax Number:
605-624-8621

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
717 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VERMILLION
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57069-3312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-624-8822
Provider Business Practice Location Address Fax Number:
605-624-8621
Provider Enumeration Date:
10/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SAUNDERS
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
605-624-8822

Provider Taxonomy Codes

  • Taxonomy code: 111NX0800X , with the licence number:  SD895 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 105356 . This is a "HEALTHPARTNERS" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 604350 . This is a "ACN" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: C895 . This is a "DAKOTACARE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 22398 . This is a "SANFORD HEALTH" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 9226770 . This is a "DAKOTACARE GROUP" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 7603364 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9226770 . This is a "CASD" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 4997915 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: DE 4226 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".




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