Organization
FERGUS FALLS MEDICAL GROUP, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN PETERSON (CHIEF EXECUTIVE OFFICER)
(218) 739-2221
Entity
Organization
Contact information
Practice address
615 S MILL ST, FERGUS FALLS, MN 56537-2756
(218) 739-2221
(218) 739-5501
Mailing address
615 S MILL ST, FERGUS FALLS, MN 56537-2756
(218) 739-2221
(218) 739-5501
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
44
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00-01587
FFMG MEDICA #
MN
05
—
10344
—
ND
01
—
109516
FFMG UCARE #
MN
05
—
533810700
—
MN
01
—
62345FE
FFMG BCBS #
MN
Enumeration date
06/12/2006
Last updated
03/26/2009
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