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General NPI Number Information
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NPI Number | 1306864905
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Entity Type | Individual
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Provider Name | ROGER R PRESZLER PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 737 BROADWAY N
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City | FARGO
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State | ND
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Zip | 58122-0001
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Country | US
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Telephone | 701-234-4811
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Fax | 701-234-6979
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Provider Business Mailing Address
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Address Line | PO BOX 67250
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City | LINCOLN
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State | NE
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Zip | 68506-7250
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Country | US
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Telephone | 402-328-2907
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Fax | 888-965-0959
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PAC0173
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License Number State | ND
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