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General NPI Number Information
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NPI Number | 1366416737
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Entity Type | Organization
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Legal Business Name | SANFORD CLINIC NORTH
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 420 SOUTH 7TH STREET
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City | OAKES
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State | ND
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Zip | 58474-2024
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Country | US
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Telephone | 701-234-2000
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Fax | 701-234-2045
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Provider Business Mailing Address
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Address Line | 420 SOUTH 7TH STREET
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City | OAKES
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State | ND
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Zip | 58474-2024
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Country | US
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Telephone | 701-742-3267
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Fax | 701-742-3201
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Authorized Official
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Title or Position | VP
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Name | MARTHA K LECLERC
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Credential |
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Telephone | 701-234-6248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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