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General NPI Number Information
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NPI Number | 1639643455
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Entity Type | Organization
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Legal Business Name | NORTH CLINIC, PA
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Dates
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Enumeration Date | 01/15/2019
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Last Update Date | 12/23/2022
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Provider Practice Location Address
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Address Line | 5109 36TH AVE N
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City | CRYSTAL
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State | MN
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Zip | 55422-2007
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Country | US
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Telephone | 763-587-7900
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Fax | 763-587-7989
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Provider Business Mailing Address
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Address Line | 5109 36TH AVE N
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City | CRYSTAL
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State | MN
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Zip | 55422-2007
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Country | US
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Telephone | 763-587-7900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SCOTT RICHARD COLSON
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Credential | MD
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Telephone | 763-587-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine 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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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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 | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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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 #7
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #8
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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 #9
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #10
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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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