Healthcare Provider Details

I. General information

NPI: 1104823434
Provider Name (Legal Business Name): JOE RICE FERGUSON III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E MAIN ST
WAYNESBORO PA
17268-2332
US

IV. Provider business mailing address

785 5TH AVENUE SUITE 3
CHAMBERSBURG PA
17201-4232
US

V. Phone/Fax

Practice location:
  • Phone: 717-765-5060
  • Fax: 717-765-5066
Mailing address:
  • Phone: 717-263-9555
  • Fax: 717-217-4218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD418761
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: