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General NPI Number Information
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NPI Number | 1619086576
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Entity Type | Organization
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Legal Business Name | RONNEY L. FERGUSON, M.D., P.C.
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 10/29/2009
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Provider Practice Location Address
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Address Line | 2051 E EVERGREEN LN SUITE A
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City | SHOW LOW
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State | AZ
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Zip | 85901
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Country | US
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Telephone | 928-537-7557
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Fax | 928-537-7594
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Provider Business Mailing Address
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Address Line | 2051 E EVERGREEN LN SUITE A
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City | SHOW LOW
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State | AZ
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Zip | 85901
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Country | US
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Telephone | 928-537-7557
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Fax | 928-537-7594
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. RONNEY LYNN FERGUSON
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Credential | M.D.
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Telephone | 928-537-7557
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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 | 28951
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License Number State | AZ
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