Provider Demographics
NPI:1508041344
Name:THE MIDLANDS CLINIC, P.C.
Entity Type:Organization
Organization Name:THE MIDLANDS CLINIC, P.C.
Other - Org Name:MIDLANDS CLINIC - CHEROKEE
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-217-5557
Mailing Address - Street 1:705 SIOUX POINT ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAKOTA DUNES
Mailing Address - State:SD
Mailing Address - Zip Code:57049-5091
Mailing Address - Country:US
Mailing Address - Phone:605-217-5500
Mailing Address - Fax:605-217-5515
Practice Address - Street 1:300 SIOUX VALLEY DR
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:IA
Practice Address - Zip Code:51012-1205
Practice Address - Country:US
Practice Address - Phone:605-217-5500
Practice Address - Fax:605-217-5515
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MIDLANDS CLINIC, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-28
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty