Organization
FAMILY TREE OB GYN, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN VAUGHN FERGUSON MD (MD OWNER)
(336) 342-6063
Entity
Organization
Contact information
Practice address
520 MAPLE AVE, SUITE C, REIDSVILLE, NC 27320-4652
(336) 342-6063
(336) 342-7847
Mailing address
520 MAPLE AVE, SUITE C, REIDSVILLE, NC 27320-4652
(336) 342-6063
(336) 342-7847
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
26070
NC
207V00000X
Obstetrics & Gynecology Physician
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012KH
BCBS
NC
05
—
89012KH
—
NC
Enumeration date
10/09/2006
Last updated
09/11/2025
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