Organization
FERGUSON MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELLEY J RUSHING (CEO)
(573) 471-0330
Entity
Organization
Contact information
Practice address
1012 N MAIN ST, SIKESTON, MO 63801-5044
(573) 471-0330
(573) 472-2966
Mailing address
PO BOX 1068, SIKESTON, MO 63801-1068
(573) 471-0330
(573) 472-2966
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207W00000X
Ophthalmology Physician
—
—
208000000X
Pediatrics Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
621758101
—
MO
Enumeration date
03/30/2007
Last updated
09/28/2009
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