Basic Information
| Provider Information | |||||||||
| NPI: | 1639593395 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TELESFORD | ||||||||
| FirstName: | NATASHA | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 353 FAIRMONT BLVD | ||||||||
| Address2: | ATTEN MSS | ||||||||
| City: | RAPID CITY | ||||||||
| State: | SD | ||||||||
| PostalCode: | 577017350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6057558110 | ||||||||
| FaxNumber: | 6057551027 | ||||||||
| Practice Location | |||||||||
| Address1: | 502 E MONROE ST | ||||||||
| Address2: | |||||||||
| City: | RAPID CITY | ||||||||
| State: | SD | ||||||||
| PostalCode: | 577011400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6057554060 | ||||||||
| FaxNumber: | 6057554012 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2014 | ||||||||
| LastUpdateDate: | 01/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2016040641 | MO | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 48270 | KY | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 35124542 | OH | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 9422 | SD | N | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.