Healthcare Provider Details

I. General information

NPI: 1245171420
Provider Name (Legal Business Name): BISON IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7862 FIREFLY LN
HORACE ND
58047-3700
US

IV. Provider business mailing address

7862 FIREFLY LN
HORACE ND
58047-3700
US

V. Phone/Fax

Practice location:
  • Phone: 701-212-2431
  • Fax:
Mailing address:
  • Phone: 701-212-2431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL KAKAYGEESICK
Title or Position: OWNER
Credential:
Phone: 701-212-2431