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Organization
FAIRLIGHT MEDICAL CENTER
Active
Organization
FAIRLIGHT MEDICAL CENTER
Active
Parent organization
WILLISTON RADIOLOGY CONSULTANTS PC
Other names
Williston Radiology Consultants
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLISTON RADIOLOGY CONSULTANTS PC
Authorized official
DR. LESZEK J JASZCZAK MD (PRESIDENT/OWNER)
(701) 577-6337
Entity
Organization
Contact information
Practice address
3 4TH ST E, WILLISTON, ND 58801-5350
(701) 577-6337
(701) 577-4867
Mailing address
3 EAST 4TH STREET, PO BOX 1148, WILLISTON, ND 58802-1148
(701) 577-6337
(701) 577-4867
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
6414
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010182
—
ND
05
—
0406731
—
MT
01
—
109956169
DUNS
ND
01
—
269-961-7243
TPIN
ND
01
—
621-111
NAICS
ND
Enumeration date
04/30/2008
Last updated
03/13/2020
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