Hayti Medical Clinic
Clinic/Center in Hayti, SD(View on Map)
Legal Business Name
Hayti Medical Clinic
NPI Number
1144570995
NPI Type
Organization
Enumeration Date
09/19/2012
Specialties
(Taxonomies)Licenses
State
South Dakota
License Number
CP000033
Contact
Information
Purpose
Mailing
Location
Address
102 MAIN AVE
102 MAIN AVE
City
Hayti
Hayti
State
SD
SD
Postal Code
57241-0238
57241-0238
Country
US
US
Telephone Number
(605) 783-3030
(605) 783-3030
Authorized Official
Name
Mr. Mitchell Jenner
Title or Position
NURSE PRACTITIONER
Telephone Number
(605) 783-3030
Identifiers
Identifier
6820663
Identifier State
SD
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/19/2012