Provider Demographics
NPI:1073541215
Name:KOSIAK, DONALD J JR (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:KOSIAK
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E 21ST ST
Mailing Address - Street 2:EMERGENCY DEPT
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1016
Mailing Address - Country:US
Mailing Address - Phone:605-322-2000
Mailing Address - Fax:605-322-2036
Practice Address - Street 1:800 E 21ST ST
Practice Address - Street 2:EMERGENCY DEPT
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1016
Practice Address - Country:US
Practice Address - Phone:605-322-2000
Practice Address - Fax:605-322-2036
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5446207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0042211OtherWELLMARK SD BC
MN492T3KOOtherMN BLUE CROSS
SD9223504OtherDAKOTACARE
NE460224743-31Medicaid
SDP00199220OtherRAILROAD MEDICARE
IA1557298Medicaid
SD460224743-57105-AF04OtherTRICARE
SD460224743-57105-AF04OtherTRICARE
H66630Medicare UPIN