Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 1784 | FL |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | E-13792 | AR |
NPI | 1619984838 |
---|---|
Provider Name | Dr. John Peter Ferris JR. |
First Address | Little Rock, AR 72225-1418 |
Second Address | Springdale, AR 72762-0845 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 28/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
279833600 | (05) | FL |