Individual
JOHN D FERRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 N BROADWAY AVE, RIVERTON, WY 82501-3545
(307) 856-0009
Mailing address
300 N BROADWAY AVE, RIVERTON, WY 82501-3545
(307) 856-0009
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
2139A
WY
208D00000X
General Practice Physician
26101
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000563350
BC BS OF KS
KS
01
—
830236758012
BCBS UNITED OF WISCONSIN
WI
05
—
89334841
—
CO
05
—
91021394
—
CO
Enumeration date
11/01/2007
Last updated
11/01/2007
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