| Heart Of America Johnson Clinic -maddock | |
|
301 Roosevelt Ave Maddock ND 58348-7138 | |
| (701) 438-2555 | |
| (701) 438-2551 |
| Full Name | Heart Of America Johnson Clinic -maddock |
|---|---|
| Speciality | Family Medicine |
| Location | 301 Roosevelt Ave, Maddock, North Dakota |
| Authorized Official Name and Position | Erik T Christenson (CEO) |
| Authorized Official Contact | 7017765261 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heart Of America Johnson Clinic -maddock 2975 Highway 2 E Rugby ND 58368 Ph: (701) 776-5455 | Heart Of America Johnson Clinic -maddock 301 Roosevelt Ave Maddock ND 58348-7138 Ph: (701) 438-2555 |
| NPI Number | 1740451038 |
|---|---|
| Provider Enumeration Date | 03/14/2008 |
| Last Update Date | 10/03/2024 |
| Medicare PECOS PAC ID | 6002716701 |
|---|---|
| Medicare Enrollment ID | O20101109001056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740451038 | NPI | - | NPPES |
| 1457113 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |