Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MD18844 | TN |
NPI | 1013965623 |
---|---|
Provider Name | Steve G. Ferguson |
First Address | Knoxville, TN 37916-3009 |
Second Address | Knoxville, TN 37916-2307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3038496 | (05) | TN |
C36427 | (02) |