BROCK J DOUBLEDEE (NPI# 1013994730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013994730 |
Entity Type | Individual |
Full Name | BROCK J DOUBLEDEE |
Credential | D.O. |
Practice Address |
1600 W 22nd Sioux Falls SD 57105-1521 |
Mailing Address |
Po Box 5074 Sioux Falls SD 57117-5074 |
Practice Telephone | 6053121000 |
Practice Fax Number | 6053121001 |
Mailing Telephone | 6053121000 |
Mailing Fax Number | 6053121001 |
Enumeration Date | 2005-12-22 |
Last Update Date | 2009-03-05 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208000000X | Pediatrics | 47322 | MN | Allopathic & Osteopathic Physicians |
Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
5852 | SD | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | 620933500 | 05 |
Street Address |
1600 W 22ND |
City | SIOUX FALLS |
State | SD |
Zip Code | 57105-1521 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
Find all providers in zip 57105 |
Taxonomy Code | 2080P0206X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Pediatric Gastroenterology |
A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174898316 | Sarah Cole | Pediatrics | 1417 S Cliff Ave Ste 10, Sioux Falls, SD 57105-1014 | 2012-03-21 |
1174570659 | Tonya R. Adamiak | Pediatrics | 1600 W 22nd St, Sioux Falls, SD 57105-1521 | 2006-05-28 |
1770559007 | Stephen Errol Nanton | Pediatrics | 1417 S. Cliff Ave, Ste 100, Sioux Falls, SD 57105-1014 | 2006-02-27 |
City | SIOUX FALLS |
Zip Code | 57105 |
Please comment or provide details below to improve the information on BROCK J DOUBLEDEE.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.