| Organization Name: | INSTITUTE OF SPECIALTY SURGERY LLC |
| NPI Number: | 1013946276 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIM HAUGEN (ADMINISTRATOR) |
| Mailing Address: | 2301 25th St S Suite H Fargo |
| State: | ND US |
| Postal Code: | 581036104 |
| Phone Number: | 7012711045 |
| Fax Number: | 7012711044 |
| NPI Enumeration Date: | 07/01/2006 |
| NPI Last Update Date: | 06/11/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |