1548205123 NPI number — YVONNE SEGER OPPOLD M.D.

Table of content: YVONNE SEGER OPPOLD M.D. (NPI 1548205123)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548205123 NPI number — YVONNE SEGER OPPOLD M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OPPOLD
Provider First Name:
YVONNE
Provider Middle Name:
SEGER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SEGER
Provider Other First Name:
YVONNE
Provider Other Middle Name:
BETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1548205123
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3718 E FOX RUN PLACE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIOUX FALLS
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57103-7196
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-553-6094
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PIPESTONE COUNTY MEDICAL CENTER & FAMILY CLINIC
Provider Second Line Business Practice Location Address:
916 4TH AVE SW
Provider Business Practice Location Address City Name:
PIPESTONE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56164-1065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-825-5811
Provider Business Practice Location Address Fax Number:
507-825-5733
Provider Enumeration Date:
06/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  67046 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X , with the licence number: 3445 , 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: 6200633 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 218380300 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6200632 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00850929 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 1969972 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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