Provider Demographics
NPI:1497727929
Name:OEHLKE, KARL KENNETH (PA)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:KENNETH
Last Name:OEHLKE
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:2400 S MINNESOTA AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-3761
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:4400 W 69TH ST
Practice Address - Street 2:STE 1500
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8170
Practice Address - Country:US
Practice Address - Phone:605-322-5700
Practice Address - Fax:605-322-5704
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2013-12-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SD0542363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN352157500Medicaid
SD9238091OtherDAKOTACARE
MN040121002OtherPRIMEWEST
ND12200Medicaid
SD30791OtherSANFORD HEALTH PLAN
MN241L9OEOtherCC SYSTEMS/ BLUE PLUS
NE46022474352Medicaid
IA3148379Medicaid
SD57108C027OtherWPS TRICARE
SD1931128OtherARAZ/ AMERICA'S PPO
SD370624200OtherDEPT OF LABOR
SD6825460Medicaid
SD241098OtherMIDLANDS CHOICE
SD412991034954OtherPREFERRED ONE
SD4995860OtherBLUE CROSS
SDHP39461OtherHEALTHPARTNERS
SD30791OtherSANFORD HEALTH PLAN
SD412991034954OtherPREFERRED ONE