Organization
FERGUS FALLS MEDICAL GROUP, P.A.
Active
Parent organization
FERGUS FALLS MEDICAL GROUP, PA
Other names
Brown's Valley Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
FERGUS FALLS MEDICAL GROUP, PA
Authorized official
JIM WILKUS (CEO)
(218) 739-2221
Entity
Organization
Contact information
Practice address
404 WEST BROADWAY, BROWN'S VALLEY, MN 56219
(320) 695-8526
Mailing address
615 S MILL ST, FERGUS FALLS, MN 56537-2756
(218) 739-2221
(218) 739-5501
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
44
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00-01587
BVC MEDICA #
MN
05
—
10344
—
ND
01
—
109516
BVC UCARE #
MN
01
—
62345FE
BVC BCBS #
MN
Enumeration date
06/19/2006
Last updated
08/17/2018
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