Individual
MR. THIMJON CRAIG FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 S 7TH ST, VINCENNES, IN 47591-1038
(812) 885-3685
(812) 885-3917
Mailing address
520 S 7TH ST, VINCENNES, IN 47591-1038
(812) 885-3685
(812) 885-3917
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01036257A
IN
207Q00000X
Family Medicine Physician
01036257
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000227039
ANTHEM INDIVIDUAL #
IN
01
—
504429
ANTHEM
—
01
—
P00417814
RAILROAD MEDICARE
IN
Enumeration date
03/25/2006
Last updated
12/17/2007
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