Individual
KEENAN L FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
405 S OKLAHOMA AVE, CHEROKEE, OK 73728-2545
(580) 596-2800
(580) 596-2805
Mailing address
900 17TH ST, WOODWARD, OK 73801-2448
(580) 596-2800
(580) 596-2805
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4405
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200088860A
—
OK
Enumeration date
01/06/2006
Last updated
04/24/2018
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