# 5TH MEDICAL GROUP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760764393
- **Authorized official:** ROBERT B LONG (INDEPENDENT DUTY MEDICAL TECHNICIAN)
- **Authorized official phone:** (701) 723-5190

## Contact information

- **Practice address:** 10 MISSILE AVE, MINOT AFB, ND 58705-5003
- **Practice address phone:** (701) 723-5190
- **Mailing address:** 10 MISSILE AVE, MINOT AFB, ND 58705-5003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2865M2000X | Military General Acute Care Hospital | B1035530 | ND | Yes |

## Other

- **Enumeration date:** 09/09/2011
- **Last updated:** 09/09/2011