Provider Demographics
NPI:1972582500
Name:KERRS ENTERPRISES
Entity Type:Organization
Organization Name:KERRS ENTERPRISES
Other - Org Name:SPRINGFIELD FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RN/OFFICE MANABER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GENA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KERR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:605-369-2627
Mailing Address - Street 1:PO BOX 5126
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5126
Mailing Address - Country:US
Mailing Address - Phone:605-369-2627
Mailing Address - Fax:605-369-5627
Practice Address - Street 1:806 8TH STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:SD
Practice Address - Zip Code:57062
Practice Address - Country:US
Practice Address - Phone:605-369-2627
Practice Address - Fax:605-369-5627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-12
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS40424Medicare PIN