Basic Information
| Provider Information | |||||||||
| NPI: | 1700852480 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HURLEY | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2400 S. MINNESOTA AVE | ||||||||
| Address2: | STE 100 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571053762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227510 | ||||||||
| FaxNumber: | 6053226475 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 S. CLIFF AVE | ||||||||
| Address2: | STE 601 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571051032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053226930 | ||||||||
| FaxNumber: | 6053226931 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2006 | ||||||||
| LastUpdateDate: | 12/13/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 2052 | SD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 407141028094 | 01 | SD | PREFERRED ONE | OTHER | 46022474347 | 05 | NE | MEDICAID | 2920926 | 05 | IA | MEDICAID | 6000515 | 05 | SD | MEDICAID | 2052 | 01 | SD | DAKOTACARE | OTHER | 4800220 | 01 | SD | MEDICA | OTHER | 27053 | 01 | SD | SANFORD HEALTH PLAN | OTHER | 606095100 | 05 | MN | MEDICAID | 38061 | 01 | IA | BLUE CROSS | OTHER | 57105W003 | 01 | SD | WPS TRICARE | OTHER | HP24408 | 01 | SD | HEALTHPARTNERS | OTHER | 0040348 | 01 | SD | BLUE CROSS | OTHER | 1529 | 01 | SD | MIDLANDS CHOICE | OTHER | 23140 | 01 | SD | ARAZ/ AMERICA'S PPO | OTHER | 286T3HU | 01 | MN | BLUE CROSS | OTHER | 286T3HU | 01 | MN | CC SYSTEMS/ BLUE PLUS | OTHER |