Organization
HOMER A FERGUSON, JR, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOMER A FERGUSON II MD (OWNER)
(618) 277-1130
Entity
Organization
Contact information
Practice address
3990 N ILLINOIS, SWANSEA, IL 62226
(618) 277-1130
(618) 277-6651
Mailing address
3990 N ILLINOIS, SWANSEA, IL 62226
(618) 277-1130
(618) 277-6651
Taxonomy
Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225033178
NPI INDIVIDUAL
IL
Enumeration date
06/14/2006
Last updated
11/20/2007
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