1588819783 NPI number — BROOKINGS FAMILY PLANNING

Table of content: TODD ALAN SMITH MD (NPI 1891776514)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588819783 NPI number — BROOKINGS FAMILY PLANNING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BROOKINGS FAMILY PLANNING
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:
SANFORD BROOKINGS FAMILY PLANNING
Provider Other Organization Name Type Code:
3
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:
1588819783
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1440 N CAMPUS DR
Provider Second Line Business Mailing Address:
WELLNESS CENTER BOX 2818
Provider Business Mailing Address City Name:
BROOKINGS
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57107-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-688-4157
Provider Business Mailing Address Fax Number:
605-688-6450

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1440 N CAMPUS DR
Provider Second Line Business Practice Location Address:
WELLNESS CENTER
Provider Business Practice Location Address City Name:
BROOKINGS
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57107-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-688-4157
Provider Business Practice Location Address Fax Number:
605-688-6450
Provider Enumeration Date:
12/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
LUNDAY
Authorized Official First Name:
TAMARA
Authorized Official Middle Name:
LYNNE
Authorized Official Title or Position:
DIRECTOR SHCCS-SDSU
Authorized Official Telephone Number:
605-688-4157

Provider Taxonomy Codes

  • Taxonomy code: 261QA0005X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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