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Individual

DR. RICKY CARROLL FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
408 W MCCLOY, MONTICELLO, AR 71655
(870) 367-8511
(870) 367-3215
Mailing address
408 W MCCLOY, MONTICELLO, AR 71655
(870) 367-8511
(870) 367-3215

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2309
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102151722
AR
01
410040927
RAILROAD MEDICARE
AR
Enumeration date
08/30/2006
Last updated
11/01/2010
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