Provider Demographics
NPI:1881651958
Name:SETLIFF, REUBEN C III (MD)
Entity Type:Individual
Prefix:
First Name:REUBEN
Middle Name:C
Last Name:SETLIFF
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 E 26TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103
Mailing Address - Country:US
Mailing Address - Phone:605-339-1872
Mailing Address - Fax:605-339-3872
Practice Address - Street 1:2709 E 26TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-4016
Practice Address - Country:US
Practice Address - Phone:605-339-1872
Practice Address - Fax:605-339-3872
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD3904207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN976215900Medicaid
SD0004987OtherBCBS
IA0937979Medicaid
WY122054300Medicaid
040011975OtherRAILROAD MEDICARE
SD5602343Medicaid
NE22199OtherBCBS
040011975OtherRAILROAD MEDICARE
B90856Medicare UPIN
NE273860Medicare ID - Type Unspecified