Organization
JOHN D FERRIS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D FERRIS MD (OWNER)
(307) 856-0009
Entity
Organization
Contact information
Practice address
300 N BROADWAY AVE, RIVERTON, WY 82501-3545
(307) 856-0009
Mailing address
300 N BROADWAY AVE, RIVERTON, WY 82501-3545
(307) 856-0009
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
2139A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000563350
BC BS OF KS
KS
01
—
010062665
RAILROAD MEDICARE
WY
05
—
108971400
—
WY
05
—
89334841
—
CO
05
—
91021394
—
CO
Enumeration date
02/22/2007
Last updated
08/21/2009
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