Individual
MR. MICHAEL THOMAS FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2146 N COVE BLVD, PANAMA CITY, FL 32405-5319
(850) 769-4040
(850) 769-4411
Mailing address
2146 COVEBOULEVARD, PANAMA CITY, FL 32405
(850) 769-4040
(850) 769-4411
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2719
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05113
SPECTARA
FL
01
—
10047
NVA
FL
01
—
10451
SVS FORD
FL
01
—
2449
DAVIS
FL
01
—
38742
AVESIS
FL
Enumeration date
05/25/2007
Last updated
07/08/2007
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