Healthcare Provider Details
I. General information
NPI: 1962753749
Provider Name (Legal Business Name): ACCESSIBLE PODIATRY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/20/2012
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
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
- Phone: 701-572-4094
- Fax: 866-851-5712
- Phone: 701-572-4094
- Fax: 866-851-5712
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GUY
SLANN
Title or Position: OWNER
Credential: D.P.M.
Phone: 701-572-4094