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General NPI Number Information
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NPI Number | 1326314808
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Entity Type | Individual
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Provider Name | ROBERT ANTHONY FERGUSON D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 2050 MEADOWVIEW PKWY
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City | KINGSPORT
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State | TN
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Zip | 37660-7475
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Country | US
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Telephone | 423-230-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 W OAKLAND AVE STE 310
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City | JOHNSON CITY
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State | TN
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Zip | 37604-2192
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Country | US
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Telephone | 423-952-2111
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 062734
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 2017-01260
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 6320
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License Number State | TN
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