Provider Demographics
NPI:1376838839
Name:DENNA, PAUL THRASHER (MD)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:THRASHER
Last Name:DENNA
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 1:803 E. MILBANK AVE.
Mailing Address - Street 2:AVERA MEDICAL GROUP MILBANK
Mailing Address - City:MILBANK
Mailing Address - State:SD
Mailing Address - Zip Code:57252
Mailing Address - Country:US
Mailing Address - Phone:605-432-4587
Mailing Address - Fax:605-432-4580
Practice Address - Street 1:13945 482ND AVE
Practice Address - Street 2:
Practice Address - City:BIG STONE CITY
Practice Address - State:SD
Practice Address - Zip Code:57216-8201
Practice Address - Country:US
Practice Address - Phone:605-214-1451
Practice Address - Fax:605-223-8719
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY9416A208D00000X
MN73544207Q00000X
SD9241207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice