Provider Demographics
NPI:1568794154
Name:DR.JOHN P. CHANEY L.L.C.
Entity Type:Organization
Organization Name:DR.JOHN P. CHANEY L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND OPERATING MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHANEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-584-1500
Mailing Address - Street 1:136A US HIGHWAY 14A
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57754-2054
Mailing Address - Country:US
Mailing Address - Phone:605-584-1500
Mailing Address - Fax:605-722-1188
Practice Address - Street 1:136A US HIGHWAY 14A
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:SD
Practice Address - Zip Code:57754-2054
Practice Address - Country:US
Practice Address - Phone:605-584-1500
Practice Address - Fax:605-722-1188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-05
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD834261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center