1245332311 NPI number — WILLIAM NOYES, MD PC

Table of content: (NPI 1245332311)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245332311 NPI number — WILLIAM NOYES, MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM NOYES, MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245332311
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/01/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1451 44TH AVE
Provider Second Line Business Mailing Address:
UNIT E
Provider Business Mailing Address City Name:
GRAND FORKS
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58201-3434
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1451 44TH AVE S
Provider Second Line Business Practice Location Address:
UNIT E
Provider Business Practice Location Address City Name:
GRAND FORKS
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58201-3434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-787-5800
Provider Business Practice Location Address Fax Number:
701-787-5802
Provider Enumeration Date:
09/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NOYES
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
RICHARD
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
701-787-5800

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  6918 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 13116 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
  • Identifier: 054429900 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 06336001 . This is a "BLUE CROSS NORHT DAKOTA" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 24047 . This is a "MEDICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 273L6NO . This is a "BLUE CROSS OF MINNESOTA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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