Organization
DAKOTA PLAINS RADIOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KEVIN MAXWELL MD (PRESIDENT)
(701) 570-2250
Entity
Organization
Contact information
Practice address
1301 15TH AVE WEST, MERCY MEDICAL CENTER, WILLISTON, ND 58801
(701) 774-7400
Mailing address
PO BOX 759, WILLISTON, ND 58802-0759
(701) 839-1066
(701) 839-5484
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12126
—
ND
01
—
5786 001
BLUE SHIELD
ND
01
—
A001 A002
TRICARE WPS
ND
Enumeration date
11/20/2006
Last updated
09/11/2025
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