Provider Demographics
NPI:1407008600
Name:CHOATE, JACQUELYN DAWN (MD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELYN
Middle Name:DAWN
Last Name:CHOATE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:JACQUELYN
Other - Middle Name:DAWN
Other - Last Name:MCHUGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 5050
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5050
Mailing Address - Country:US
Mailing Address - Phone:605-322-7200
Mailing Address - Fax:
Practice Address - Street 1:1301 S CLIFF AVE
Practice Address - Street 2:SUITE 700
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:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD7788207ZP0102X
MN105543207ZP0102X
NE26285207ZP0102X
IA39572207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology