# WILLISTON RADIOLOGY CONSULTANTS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fairlight Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942375852
- **Authorized official:** DR. LESZEK J JASZCZAK M.D. (PRESIDENT)
- **Authorized official phone:** (701) 577-6337

## Contact information

- **Practice address:** 3 4TH ST E, SUITE 201, WILLISTON, ND 58801-5350
- **Practice address phone:** (701) 577-4867
- **Mailing address:** PO BOX 1148, WILLISTON, ND 58802-1148
- **Mailing address phone:** (701) 577-4867
- **Mailing address fax:** (701) 577-4867

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 7782 | ND | Yes |

## Other

- **Enumeration date:** 11/24/2006
- **Last updated:** 03/13/2020