# JOE RICE FERGUSON III

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1104823434
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD418761 | PA | Yes |

## Other

- **Enumeration date:** 07/01/2005
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001972175 0004 | — | PA |
| 01 | — | 1104823434 | HEALTH AMERICA | PA |
| 01 | — | 120420414 | DEPT OF LABOR | PA |
| 01 | — | 1525332 | HIGHMARK BLUE SHIELD | PA |
| 01 | — | 2179950 | MAMSI | PA |
| 01 | — | 25-1716306 | GREATWEST | PA |
| 01 | — | 3369154 | AETNA HMO | PA |
| 01 | — | 50078951 | CAPITAL BLUECROSS | PA |
| 01 | — | 7694509 | AETNA NON-HMO | PA |
| 01 | — | 867633 | MEDICARE GROUP \# | PA |
| 01 | — | MD418761 | LICENSE | PA |
| 01 | — | P00708433 | RAILROAD MEDICARE | PA |