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Contact Information

MARK S KRISTY, MD
1000 HIGHWAY 12
HETTINGER, ND58639-7530
 Phone: 701-567-4561
 Fax: 701-567-6363
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for MARK S KRISTY · (Male)

NPI Number 1609974195
Status Active
Credentials MD
Entity Individual
Enumeration date 09/20/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • ND License # 7219
  • IA Medicaid 1914556
  • MN Medicaid 658162-00
  • ND Medicaid 18409
  • NE Medicaid 4503468812
  • SD Medicaid 7781732
  • Other A13801044310 PREFERREDONE
  • ND Other 13032 BC/BS
Hospital affiliation(s)
  • WEST RIVER REGIONAL MEDICAL CENTER-CAH - (Critical Access)
    1000 HIGHWAY 12
    HETTINGER, ND 58639
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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