Provider Demographics
NPI:1083694608
Name:ASKEGARD, JOHANNA R (MD)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:R
Last Name:ASKEGARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOHANNA
Other - Middle Name:R
Other - Last Name:ASKEGARD-GIESMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:701-234-2000
Mailing Address - Fax:
Practice Address - Street 1:801 BROADWAY N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-3641
Practice Address - Country:US
Practice Address - Phone:701-234-3467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN47606208600000X
ND136642086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN881487200Medicaid
MN020002889Medicare PIN
MN881487200Medicaid
MN881487200Medicaid