Provider Demographics
NPI:1871589531
Name:OPHTHALMOLOGY LTD
Entity type:Organization
Organization Name:OPHTHALMOLOGY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-336-6294
Mailing Address - Street 1:6601 S MINNESOTA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2564
Mailing Address - Country:US
Mailing Address - Phone:605-336-6294
Mailing Address - Fax:605-336-0266
Practice Address - Street 1:6601 S MINNESOTA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2564
Practice Address - Country:US
Practice Address - Phone:605-336-6294
Practice Address - Fax:605-336-0266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA25529OtherWELMARK OF IA
SD0000131OtherBLUE SHIELD SD
IA0741660Medicaid
MN121854D375OtherUCARE MN
MN91128OPOtherBLUE SHIELD MN
MN68A69OPOtherBLUE SHIELD MN
MN802S0OPOtherBLUE SHIELD MN
MN318430000Medicaid
IA52223OtherWELLMARK OF IA
19431OtherHEALTHPARTNERS
IA0741660Medicaid
SDCI6960Medicare PIN
MN68A69OPOtherBLUE SHIELD MN
IA52223OtherWELLMARK OF IA
19431OtherHEALTHPARTNERS
MN121854D375OtherUCARE MN
MN318430000Medicaid
SD0256640001Medicare NSC