Provider Demographics
NPI:1962753749
Name:ACCESSIBLE PODIATRY, P.C.
Entity type:Organization
Organization Name:ACCESSIBLE PODIATRY, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:SLANN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:701-572-4094
Mailing Address - Street 1:3 4TH ST E
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-5350
Mailing Address - Country:US
Mailing Address - Phone:701-572-4094
Mailing Address - Fax:866-851-5712
Practice Address - Street 1:3 4TH ST E
Practice Address - Street 2:SUITE 102
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-5350
Practice Address - Country:US
Practice Address - Phone:701-572-4094
Practice Address - Fax:866-851-5712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty