Provider Demographics
NPI:1619373065
Name:JAMES D KERR
Entity Type:Organization
Organization Name:JAMES D KERR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:KERR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-660-9958
Mailing Address - Street 1:613 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-3645
Mailing Address - Country:US
Mailing Address - Phone:605-660-9958
Mailing Address - Fax:605-689-3101
Practice Address - Street 1:613 WALNUT ST
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-3645
Practice Address - Country:US
Practice Address - Phone:605-660-9958
Practice Address - Fax:605-689-3101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-12
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD2720261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5602744Medicaid
SD5602744Medicaid