Provider Demographics
NPI:1639281140
Name:TIMOTHY A FERRUGIA MD PC
Entity Type:Organization
Organization Name:TIMOTHY A FERRUGIA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:FERRUGIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-867-2656
Mailing Address - Street 1:1000 LINCOLN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FORT MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701-3210
Mailing Address - Country:US
Mailing Address - Phone:970-867-2656
Mailing Address - Fax:970-542-9608
Practice Address - Street 1:1000 LINCOLN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-3210
Practice Address - Country:US
Practice Address - Phone:970-867-2656
Practice Address - Fax:970-542-9608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44940208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty