Individual
VINCENT FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
138 W GIBSON ST, HARTWELL, GA 30643-1847
(904) 805-1300
(904) 805-1302
Mailing address
PO BOX 532723, ATLANTA, GA 30353-2723
(904) 805-1300
(904) 805-1302
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
37203
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007073
BLUE CROSS
GA
05
—
G37203
—
SC
Enumeration date
07/07/2006
Last updated
07/09/2007
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