Provider Demographics
NPI:1114947678
Name:BONE AND JOINT CENTER, PC
Entity Type:Organization
Organization Name:BONE AND JOINT CENTER, PC
Other - Org Name:COMMUNITY MRI SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-530-8800
Mailing Address - Street 1:600 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4112
Mailing Address - Country:US
Mailing Address - Phone:701-355-4300
Mailing Address - Fax:701-355-4301
Practice Address - Street 1:600 N 9TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4112
Practice Address - Country:US
Practice Address - Phone:701-355-4300
Practice Address - Fax:701-355-4301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BONE & JOINT CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-20
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND711252Medicare ID - Type Unspecified