| NPI | 1154695278 |
|---|---|
| Doing Business As | SANFORD CHILDREN'S CLINIC DUNCAN |
| Entity Type | Organization |
| Authorized Contact | JIM SLACK Vice President 605-312-6535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |