Individual
LEONARD JAY FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
(808) 433-5000
Mailing address
2180 MAIN ST, WAILUKU, HI 96793-1666
(808) 242-6464
(808) 242-4292
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
AMD-305
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AMD-305
HI. LIC
HI
Enumeration date
06/13/2008
Last updated
07/30/2024
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