Healthcare Provider Details

I. General information

NPI: 1487945630
Provider Name (Legal Business Name): GUY K SLANN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2011
Last Update Date: 03/14/2026
Certification Date: 03/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 MAIN ST STE 104
WILLISTON ND
58801-5457
US

IV. Provider business mailing address

322 MAIN ST STE 104
WILLISTON ND
58801-5457
US

V. Phone/Fax

Practice location:
  • Phone: 701-572-4094
  • Fax: 866-851-5712
Mailing address:
  • Phone: 701-572-4094
  • Fax: 866-851-5712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number66
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: