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General NPI Number Information
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NPI Number | 1013233295
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Entity Type | Individual
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Provider Name | MATTHEW PAUL FERGUSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2010
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 3601 4TH ST
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City | LUBBOCK
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State | TX
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Zip | 79430-0002
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Country | US
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Telephone | 806-743-2475
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Fax | 806-743-1394
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Provider Business Mailing Address
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Address Line | 3601 4TH STREET STOP 9436
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City | LUBBOCK
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State | TX
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Zip | 79430
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Country | US
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Telephone | 806-743-1703
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Fax | 806-743-1020
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | P7271
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | P7271
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License Number State | TX
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