Organization
FERGUSON MEDICAL GROUP RURAL HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES SHILL (CEO)
(573) 471-0330
Entity
Organization
Contact information
Practice address
115 E BUSINESS US HIGHWAY 60, DEXTER, MO 63841-1219
(573) 614-5007
Mailing address
PO BOX 1068, SIKESTON, MO 63801-1068
(573) 471-0330
(573) 481-5019
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18011
BLUE CROSS BLUE SHIELD
MO
Enumeration date
10/01/2007
Last updated
07/21/2022
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