Provider Demographics
NPI:1437271301
Name:ABERDEEN FAMILY PHYSICIANS
Entity type:Organization
Organization Name:ABERDEEN FAMILY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:OPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-225-0378
Mailing Address - Street 1:105 S STATE ST
Mailing Address - Street 2:SUITE 113
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-4500
Mailing Address - Country:US
Mailing Address - Phone:605-225-0378
Mailing Address - Fax:605-225-7919
Practice Address - Street 1:105 S STATE ST
Practice Address - Street 2:SUITE 113
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4500
Practice Address - Country:US
Practice Address - Phone:605-225-0378
Practice Address - Fax:605-225-7919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1379291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory