Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 42125 | TN |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 42125 | TN |
NPI | 1215067996 |
---|---|
Provider Name | Christopher Allen Ferguson |
First Address | Memphis, TN 38119-5742 |
Second Address | Bartlett, TN 38133-4004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 20/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00756290 | MEDICARE RR (01) | TN |
1514483 | (05) | TN |
4228438 | BCBS OF TN (01) | TN |
I73752 | (02) |