Individual
ALISA BETH FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
220 HAWTHORNE PARK, ATHENS, GA 30606-2148
(706) 548-0500
(706) 548-3575
Mailing address
3320 OLD JEFFERSON RD BLDG 700, ATHENS, GA 30607-1465
(706) 353-2990
(706) 353-2992
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/06/2022
Last updated
07/16/2024
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