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Individual

KEVIN F FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-1524
(570) 271-7910
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578

Taxonomy

Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
219101-1
NY
2080P0214X
Pediatric Pulmonology Physician
Primary
MD472414
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001397240
CT
Enumeration date
11/14/2005
Last updated
01/25/2021
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