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FERGUS FALLS MEDICAL GROUP P.A. NPI 1619915543


NPI Information

NPI: 1619915543
Provider Name: FERGUS FALLS MEDICAL GROUP, P.A.

Other Name: WHEATON CLINIC

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
403 12TH ST N
WHEATON, MN
ZIP 56296
Phone: (320) 563-8295
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FERGUS FALLS MEDICAL GROUP, P.A. is a clinic center in Wheaton, MN. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). FERGUS FALLS MEDICAL GROUP, P.A. NPI is 1619915543. The provider is registered as an organization entity type.
The provider Other Name Is Wheaton Clinic.

The provider's business location address is:

403 12TH ST N
WHEATON, MN
ZIP 56296-070
Phone: (320) 563-8295
Fax: (320) 563-8014

The provider's authorized official is Jim Wilkus .
The authorized official title is Ceo and has the following contact phone number (218) 739-2221.

The enumeration date for this NPI number is 6/3/2006 and was last updated on 8/17/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center44MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1=========OTHERMINNESOTAWC PREFERRED ONE #
262345FEOTHERMINNESOTAWC BCBS #
300-01587OTHERMINNESOTAWC MEDICA #
410344MEDICAIDNORTH DAKOTA
5109516OTHERMINNESOTAWC UCARE #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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