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Individual

ZACHARY L FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 686-4151
Mailing address
4004 STATE HIGHWAY M, POPLAR BLUFF, MO 63901-9233

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2019003623
MO
363A00000X
Physician Assistant
Primary
2019003623
MO

Other

Enumeration date
02/04/2019
Last updated
04/30/2026
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