Organization
FERGUS FALLS MEDICAL GROUP, P.A.
Active
Other names
Westridge Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JIM WILKUS (CEO)
(218) 739-5281
Entity
Organization
Contact information
Practice address
2001 W LINCOLN AVE, SUITE 56, FERGUS FALLS, MN 56537-1010
(218) 739-5281
(218) 739-5283
Mailing address
615 S MILL ST, FERGUS FALLS, MN 56537-2756
(218) 739-2221
(218) 739-5501
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00-01587
WRC MEDICA #
MN
05
—
10344
—
ND
01
—
109516
WRC UCARE #
MN
01
—
62345FE
WRC BCBS #
MN
Enumeration date
06/02/2006
Last updated
08/22/2020
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