Provider Demographics
NPI:1982604690
Name:BELKHAM, BARBARA A (PA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:BELKHAM
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:A
Other - Last Name:ROEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-9556
Mailing Address - Fax:605-328-9501
Practice Address - Street 1:3401 W 49TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-2318
Practice Address - Country:US
Practice Address - Phone:605-328-1850
Practice Address - Fax:605-328-1855
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0394363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6821846Medicaid
SD970030003Medicare PIN
SD970029995Medicare PIN
SDP21334Medicare UPIN
SD6821846Medicaid