Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | SC002846L | PA |
N | 222Z00000X | Podiatrist | SC002846L | PA |
N | 2081S0010X | Sports Medicine | SC002846L | PA |
N | 213ES0000X | Sports Medicine | SC002846L | PA |
N | 213ES0131X | Foot Surgery | SC002846L | PA |
NPI | 1447210547 |
---|---|
Provider Name | Dr. Ronald W Ferguson JR. |
First Address | North Huntingdon, PA 15642-2772 |
Second Address | North Huntingdon, PA 15642-2772 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T30013 | (02) | PA |