Individual
DR. SCOT MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3318 N 14TH ST, BISMARCK, ND 58503-1614
(701) 323-8870
(701) 323-8305
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13730
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1468482
—
ND
Enumeration date
07/10/2013
Last updated
12/14/2022
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