Provider Demographics
NPI:1134708126
Name:FINCK, JORDAN RAY (DPM)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:RAY
Last Name:FINCK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:JORDAN
Other - Middle Name:RAY
Other - Last Name:FINCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:172 4TH ST SE
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:SD
Mailing Address - Zip Code:57350-2590
Mailing Address - Country:US
Mailing Address - Phone:605-353-6200
Mailing Address - Fax:
Practice Address - Street 1:172 4TH ST SE
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350-2590
Practice Address - Country:US
Practice Address - Phone:605-353-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD258213E00000X
390200000X
SDPENDING213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program