Physician Compare National (NPI:1659312205)

HEALTHCARE PROVIDER: HAROLD ALLEN FERGUSON JR. D.O.

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

Individual Professional Information
NPI	1659312205
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4789648213
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100311000908
	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	HAROLD
	Individual professional first name
Provider Middle Name	ALLEN
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	450 B WASHINGTON JACKSON RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 102
	Group Practice or individual's line 2 address
City	EATON
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	453208699
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	360133
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GRANDVIEW AND SOUTHVIEW HOSPITALS
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	361331
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	FAYETTE COUNTY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	150048
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	REID HOSPITAL & HEALTH CARE SERVICES
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	360051
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MIAMI VALLEY HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	360079
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	KETTERING MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1659312205)

HEALTHCARE PROVIDER: HAROLD ALLEN FERGUSON JR. D.O.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information