Provider Demographics
NPI:1134119761
Name:RABBITT, DANIEL S (OD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:S
Last Name:RABBITT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:SCOTT
Other - Last Name:RABBITT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 1993
Mailing Address - Street 2:
Mailing Address - City:N SIOUX CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57049-1993
Mailing Address - Country:US
Mailing Address - Phone:605-232-3937
Mailing Address - Fax:605-235-1350
Practice Address - Street 1:206 MILITARY RD
Practice Address - Street 2:
Practice Address - City:N SIOUX CITY
Practice Address - State:SD
Practice Address - Zip Code:57049
Practice Address - Country:US
Practice Address - Phone:605-232-3937
Practice Address - Fax:605-235-1350
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0547152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10024990600Medicaid
SD0005536OtherBLUE CROSS BLUE SHIELD
IA0541748Medicaid
SD9200623Medicaid
20033OtherSPECTERA
29577OtherAVESIS
20033OtherSPECTERA
U69432Medicare UPIN