Provider Demographics
NPI:1093133258
Name:TJARKS, BRIAN JOEL (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:JOEL
Last Name:TJARKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:818 E BRIAN ST
Mailing Address - Street 2:APT 40
Mailing Address - City:TEA
Mailing Address - State:SD
Mailing Address - Zip Code:57064-2462
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 S CLIFF AVE STE 700
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1019
Practice Address - Country:US
Practice Address - Phone:605-322-7200
Practice Address - Fax:605-322-7222
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD11290207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology