Physician Compare National (NPI:1629031604)

HEALTHCARE PROVIDER: EDGAR SCOTT FERGUSON SR. MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1629031604
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5496742173
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060126000869
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FERGUSON
	Individual professional last name
Provider First Name	EDGAR
	Individual professional first name
Provider Middle Name	SCOTT
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1975
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	NUCLEAR MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	NUCLEAR MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	200 S RHODES B
	Group Practice or individual's line 1 address
City	WEST MEMPHIS
	Group Practice or individual's city
State	AR
	Group Practice or individual's state
Zip Code	723014212
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	040069
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GREAT RIVER MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	040085
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HELENA REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	041316
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SOUTH MISSISSIPPI COUNTY REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y