Individual
DONALD FERGUSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
325 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6062
(423) 439-6242
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 433-6039
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
ML7576
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3401356
LAB MEDICARE PIN
TN
Enumeration date
12/19/2007
Last updated
12/19/2007
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