Organization

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)

Code

261Q00000X

Primary Taxonomy

Yes

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

Provider Address