Organization
VALLEY IMAGING PARTNERS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDRICK JORDAN FERGUSON MD (PRESIDENT)
(423) 591-2632
Entity
Organization
Contact information
Practice address
1000 HWY 28, JASPER, TN 37347
(423) 591-2632
(423) 837-9549
Mailing address
P.O. BOX 97, JASPER, TN 37347
(423) 591-2632
(423) 837-9549
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0000026307
TN
2085R0202X
Diagnostic Radiology Physician
Primary
MD26307
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1507509
—
TN
01
—
4191955
BLUE CROSS BLUE SHIELD
TN
Enumeration date
08/27/2008
Last updated
07/01/2009
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