Organization
JACKSON W LIND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKSON W LIND M.D. (PRESIDENT)
(701) 241-9300
Entity
Organization
Contact information
Practice address
2301 25TH ST S, SUITE I, FARGO, ND 58103-6104
(701) 241-9300
(701) 235-4525
Mailing address
2301 25TH ST S, SUITE I, FARGO, ND 58103-6104
(701) 241-9300
(701) 235-4525
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
2756
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18654
—
ND
Enumeration date
09/25/2007
Last updated
10/10/2007
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