Individual
PHILIP JYSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2422 20TH ST SW, JAMESTOWN, ND 58401-6201
(701) 252-1050
(701) 952-3265
Mailing address
2422 20TH ST SW, JAMESTOWN, ND 58401-6201
(701) 252-1050
(701) 952-3265
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5832
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10973
BLUE CROSS
ND
05
—
16445
—
ND
01
—
3941009
MEDICA
—
01
—
449161007916
PREFERRED ONE
—
01
—
HP42318
HEALTH PARTNERS
—
Enumeration date
04/11/2006
Last updated
08/05/2011
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