Basic Information
| Provider Information | |||||||||
| NPI: | 1467548727 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MERRIGAN | ||||||||
| FirstName: | TRICIA | ||||||||
| MiddleName: | LAWRENCE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | LAWRENCE | ||||||||
| OtherFirstName: | TRICIA | ||||||||
| OtherMiddleName: | LEE ANN | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 911 E 20TH ST | ||||||||
| Address2: | STE 700 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571051042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053340393 | ||||||||
| FaxNumber: | 6053346028 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 E 23RD ST | ||||||||
| Address2: | STE 360 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571052108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053223950 | ||||||||
| FaxNumber: | 6053223960 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 12/23/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 8158 | SD | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 7302820 | 05 | SD | MEDICAID |