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Organization

INSTITUTE OF SPECIALTY SURGERY LLC

Active
Other names
Institute for Special Surgery
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TIM HAUGEN CPA (ADMINISTRATOR)
(701) 271-1045
Entity
Organization

Contact information

Practice address
2301 25TH ST S, SUITE H, FARGO, ND 58103-6104
(701) 271-1045
(701) 271-1044
Mailing address
2301 25TH ST S, SUITE H, FARGO, ND 58103-6104
(701) 271-1045
(701) 271-1044

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10846
ND
05
395014000
MN
Enumeration date
07/01/2006
Last updated
06/11/2010
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