# FAMILY MEDICAL CLINIC PC

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

## Provider details

- **NPI number:** 1952331159
- **Authorized official:** DR. BARBARA SHEETS OLSON MD (PRESIDENT)
- **Authorized official phone:** (701) 683-4711

## Contact information

- **Practice address:** 10 9TH AVE E, LISBON, ND 58054
- **Practice address phone:** (701) 683-4711
- **Practice address fax:** (701) 683-3205
- **Mailing address:** 10 9TH AVE E, PO BOX 1049, LISBON, ND 58054
- **Mailing address phone:** (701) 683-4711
- **Mailing address fax:** (701) 683-3205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 4909 | ND | Yes |

## Other

- **Enumeration date:** 07/04/2006
- **Last updated:** 07/31/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 05171 | — | ND |
| 05 | — | 13746 | — | ND |
| 01 | — | 1956001 | NDBS | ND |