Provider Demographics
NPI:1457863185
Name:BAKKEN OCCUPATIONAL HEALTH PC
Entity Type:Organization
Organization Name:BAKKEN OCCUPATIONAL HEALTH PC
Other - Org Name:CONSERVATIVE CARE OCCUPATIONAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-355-6633
Mailing Address - Street 1:PO BOX 1065
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-1065
Mailing Address - Country:US
Mailing Address - Phone:479-725-3044
Mailing Address - Fax:479-725-3098
Practice Address - Street 1:3410 4TH AVE W STE 2000
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-3844
Practice Address - Country:US
Practice Address - Phone:701-355-6633
Practice Address - Fax:701-354-4865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-03
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND14678174400000X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty