Organization
FERGUSON MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEY J RUSHING (CEO)
(573) 471-0330
Entity
Organization
Contact information
Practice address
320 N LINCOLN ST, EAST PRAIRIE, MO 63845-1160
(573) 649-3026
Mailing address
320 N LINCOLN ST, EAST PRAIRIE, MO 63845-1160
(573) 649-3026
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
501758106
—
MO
Enumeration date
02/22/2007
Last updated
08/22/2020
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