Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | E1390 | AR |
NPI | 1053491811 |
---|---|
Provider Name | Dr. Scott Frazier Ferguson |
First Address | Little Rock, AR 72211-4349 |
Second Address | Harrison, AR 72601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 21/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
143546001 | (05) | AR |
H30673 | (02) |