Provider Demographics
NPI:1053383539
Name:SOUNDY, TIMOTHY JAMES (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:JAMES
Last Name:SOUNDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 86370
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57118-6370
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:4400 W 69TH ST
Practice Address - Street 2:STE 1500
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8170
Practice Address - Country:US
Practice Address - Phone:605-322-5700
Practice Address - Fax:605-322-5704
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD35582084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN140M2SOOtherCC SYSTEMS/ BLUE PLUS
MN142414OtherUCARE
SD23277OtherARAZ/ AMERICA'S PPO
MN819888800Medicaid
SD57108C013OtherWPS TRICARE
MT0073831Medicaid
SD260050648OtherRR MEDICARE
SD29443OtherSANFORD HEALTH PLAN
SD3558OtherDAKOTACARE
IA3989442Medicaid
NE46022474352Medicaid
ND12200Medicaid
SD10665OtherMIDLANDS CHOICE
SDHP24852OtherHEALTHPARTNERS
SD0040482OtherBLUE CROSS
SD412991028159OtherPREFERRED ONE
SD7100924Medicaid
MN142414OtherUCARE
IA3989442Medicaid