Individual
DR. TIFFANY R FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1600 W UNIVERSITY BLVD, DURANT, OK 74701-3045
(580) 924-5500
(580) 924-1991
Mailing address
1600 W UNIVERSITY BLVD, DURANT, OK 74701-3045
(580) 924-5500
(580) 924-1991
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4677
OK
207Q00000X
Family Medicine Physician
4677
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37105
OBNDD
OK
01
—
402616
PTAN
OK
01
—
4677
STATE LICENSURE
OK
Enumeration date
08/19/2008
Last updated
03/21/2023
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