Avera Mckennan
May also be knows as Avera Medical Group Fairfax
Clinic/Center in Fairfax, SD(View on Map)
Legal Business Name
Avera Mckennan
Also Known As
Avera Medical Group Fairfax
NPI Number
1215967203
NPI Type
Organization
Enumeration Date
07/04/2006
Specialties
(Taxonomies)Contact
Information
Purpose
Mailing
Location
Address
PO BOX 354
421 MAIN ST
City
Fairfax
Fairfax
State
SD
SD
Postal Code
57335-0354
57335-0354
Country
US
US
Telephone Number
(605) 654-2366
(605) 654-2366
Authorized Official
Name
Julie Norton
Title or Position
VICE PRESIDENT OF FINANCE
Telephone Number
(605) 322-6375
Identifiers
Identifier
0000028
Identifier State
SD
Identifier Issuer
WELLMARK BC/BS
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 03/21/2011