| Fergus Falls Medical Group, P.a. | |
|
404 West Broadway Brown's Valley MN 56219 | |
| (320) 695-8526 | |
| Not Available |
| Full Name | Fergus Falls Medical Group, P.a. |
|---|---|
| Speciality | Clinic/center |
| Location | 404 West Broadway, Brown's Valley, Minnesota |
| Authorized Official Name and Position | Jim Wilkus (CEO) |
| Authorized Official Contact | 2187392221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fergus Falls Medical Group, P.a. 615 S Mill St Fergus Falls MN 56537-2756 Ph: (218) 739-2221 | Fergus Falls Medical Group, P.a. 404 West Broadway Brown's Valley MN 56219 Ph: (320) 695-8526 |
| NPI Number | 1750326070 |
|---|---|
| Provider Enumeration Date | 06/19/2006 |
| Last Update Date | 08/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750326070 | NPI | - | NPPES |
| 00-01587 | Other | MN | BVC MEDICA # |
| 10344 | Medicaid | ND | |
| 62345FE | Other | MN | BVC BCBS # |
| 109516 | Other | MN | BVC UCARE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 44 (Minnesota) | Primary |