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683 State Ave Suite E Dickinson ND 58601-4660 | |
(701) 483-4561 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 683 State Ave, Dickinson, North Dakota |
Authorized Official Name and Position | James Long (CEO) |
Authorized Official Contact | 7015676184 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1000 Highway 12 Hettinger ND 58639-7530 Ph: (701) 567-4561 | 683 State Ave Suite E Dickinson ND 58601-4660 Ph: (701) 483-4561 |
NPI Number | 1629169008 |
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Provider Enumeration Date | 09/28/2006 |
Last Update Date | 03/28/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629169008 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
261QP1100X | Clinic/center - Podiatric | (* (Not Available)) | Secondary |
Ideal Option, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 44 24th St E, Dickinson, ND 58601 Phone: 877-522-1275 Fax: 509-491-3031 | |
Ideal Option, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1260 W Villard St Unit 1, Dickinson, ND 58601 Phone: 877-522-1275 Fax: 509-491-3031 | |