Provider Demographics
NPI:1336432228
Name:ORTHOPEDICS INTERNATIONAL LLC
Entity Type:Organization
Organization Name:ORTHOPEDICS INTERNATIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:K
Authorized Official - Last Name:FUKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-689-6890
Mailing Address - Street 1:2007 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-2030
Mailing Address - Country:US
Mailing Address - Phone:605-689-6890
Mailing Address - Fax:605-689-6896
Practice Address - Street 1:2007 LOCUST ST
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-2030
Practice Address - Country:US
Practice Address - Phone:605-689-6890
Practice Address - Fax:605-689-6896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4099207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty