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Contact Information

DAVID R LONBAKEN, DPM
100 MAC LANE
AVERA MEDICAL GROUP PIERRE
PIERRE, SD57501
 Phone: 605-224-7070
 Fax: 605-224-2514
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for DAVID R LONBAKEN · (Male)

NPI # 1760458202
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 02/24/2006
Last updated 04/04/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • SD License # 131
  • SD License # SD131
  • SD Medicaid 6800190
Hospital affiliation(s)
  • PHS INDIAN HOSPITAL AT EAGLE BUTTE - (Acute Care)
    317 MAIN STREET
    EAGLE BUTTE, SD 57625
  • ST MARY'S HOSPITAL - (Acute Care)
    801 E SIOUX
    PIERRE, SD 57501
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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