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General NPI Number Information
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NPI Number | 1609818871
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Entity Type | Individual
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Provider Name | JOHN DOUGLAS FERGUSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 701 UNIVERSITY BLVD E SUITE 602
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City | TUSCALOOSA
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State | AL
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Zip | 35401-2086
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Country | US
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Telephone | 205-759-4228
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Fax | 205-345-0841
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Provider Business Mailing Address
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Address Line | 701 UNIVERSITY BLVD E SUITE 602
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City | TUSCALOOSA
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State | AL
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Zip | 35401-2086
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Country | US
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Telephone | 205-759-4228
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Fax | 205-345-0841
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 10792
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License Number State | AL
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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 | R3B38
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License Number State | MO
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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 | 11268
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License Number State | OK
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