Healthcare Provider Details

I. General information

NPI: 1649338724
Provider Name (Legal Business Name): JAMES L. FRISK, M.D., LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 10/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 12TH AVE S SUITE D
FARGO ND
58103-8723
US

IV. Provider business mailing address

2700 12TH AVE S SUITE D
FARGO ND
58103-8723
US

V. Phone/Fax

Practice location:
  • Phone: 701-235-1924
  • Fax: 701-235-6304
Mailing address:
  • Phone: 701-235-1924
  • Fax: 701-235-6304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES L FRISK
Title or Position: PRESIDENT
Credential: M.D.
Phone: 701-235-1924