Individual
VICTOR S FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1606 N 7TH ST, TERRE HAUTE, IN 47804-2706
(812) 238-7000
Mailing address
PO BOX 2505, INDIANAPOLIS, IN 46206-2505
(812) 238-7783
(812) 238-4506
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01056125A
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
01056125A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200375170
—
IN
01
—
P00234793
RR MEDICARE
IN
Enumeration date
01/19/2007
Last updated
10/18/2010
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