Organization
FERGUSON MEDICAL LABORATORIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL P HURLY M.D. (PRESIDENT)
(417) 623-6330
Entity
Organization
Contact information
Practice address
1801 W 32ND ST BLDG B, SUITE 101, JOPLIN, MO 64804-1528
(417) 623-6330
(417) 623-3950
Mailing address
PO BOX 20452, FML-CREDENTIALING, COLUMBUS, OH 43220-0452
(614) 442-2406
(614) 442-2410
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
26D0445616
MO
291U00000X
Clinical Medical Laboratory
26D0445668
MO
291U00000X
Clinical Medical Laboratory
26D0666300
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00002307
NHC HEALTH
—
05
—
100410710A
—
KS
01
—
183098
HEALTHLINK
—
01
—
2182
BCBS
MO
01
—
690077013
RR MEDICARE
MO
05
—
700432206
—
MO
01
—
CN6673
RR MEDICARE
MO
01
—
CN6673
TRAVELERS
—
01
—
F21460
MERCY
—
Enumeration date
12/06/2005
Last updated
01/27/2015
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