Provider Demographics
NPI:1912060757
Name:REGIONAL HEALTH PHYSICIANS INC
Entity type:Organization
Organization Name:REGIONAL HEALTH PHYSICIANS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:GIESEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-719-8706
Mailing Address - Street 1:930 N 10TH STREET
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-2202
Mailing Address - Country:US
Mailing Address - Phone:605-642-6337
Mailing Address - Fax:605-642-6339
Practice Address - Street 1:930 N 10TH STREET
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-2202
Practice Address - Country:US
Practice Address - Phone:605-642-6337
Practice Address - Fax:605-642-6339
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGIONAL HEALTH PHYSICIANS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-19
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR017037261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5100140Medicaid
SDH99303Medicare UPIN