Organization
FERGUS FALLS MEDICAL GROUP, P.A.
Active
Organization
FERGUS FALLS MEDICAL GROUP, P.A.
Active
Other names
Battle Lake Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JIM WILKUS (CEO)
(218) 739-2221
Entity
Organization
Contact information
Practice address
410 LAKE AVE S, BATTLE LAKE, MN 56515
(218) 864-5283
(218) 864-8452
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
BLC MEDICA #
MN
01
—
115098
BLC UCARE #
MN
05
—
13380
—
ND
01
—
62345FE
BLC BCBS #
MN
Enumeration date
06/15/2006
Last updated
08/22/2020
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