Organization
ORTHOPEDIC AND SPORT MEDICINE SPECIALISTS OF FARGO LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP Q JOHNSON M.D. (OWNER)
(701) 478-0307
Entity
Organization
Contact information
Practice address
2829 UNIVERSITY DR S, SUITE 2, FARGO, ND 58103-6050
(701) 478-0307
Mailing address
2829 UNIVERSITY DR S, SUITE 2, FARGO, ND 58103-6050
(701) 478-0307
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Enumeration date
10/01/2010
Last updated
07/12/2011
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