Provider Demographics
NPI:1306846993
Name:RECTOR, MARK A (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:RECTOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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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:605-328-9556
Mailing Address - Fax:605-328-9501
Practice Address - Street 1:3401 W 49TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-2318
Practice Address - Country:US
Practice Address - Phone:605-328-1850
Practice Address - Fax:605-328-1855
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD5048207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5611266Medicaid
SD5611266Medicaid
SDH66988Medicare UPIN
SD080188061Medicare PIN
SD080193518Medicare PIN