Provider Demographics
NPI:1942325428
Name:BANDETTINI, FRANCIS CHRISTOPHER (DO)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:CHRISTOPHER
Last Name:BANDETTINI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:BALTIC
Mailing Address - State:SD
Mailing Address - Zip Code:57003-0432
Mailing Address - Country:US
Mailing Address - Phone:605-367-9476
Mailing Address - Fax:605-367-9481
Practice Address - Street 1:2500 W 49TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6580
Practice Address - Country:US
Practice Address - Phone:605-367-9476
Practice Address - Fax:605-367-9481
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDSD35092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE6137OtherMIDLANDS CHOICE
SD23382OtherSANFORD HEALTH(SVHP)
IA3953687Medicaid
SD0008021OtherWELLMARK-BCBS
SD8732237OtherDAKOTACARE
SD7100224Medicaid
SD0008021OtherWELLMARK-BCBS
NE6137OtherMIDLANDS CHOICE