Individual
ADAM V FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
7777 HENNESSY BLVD, ST. 701, BATON ROUGE, LA 70808-4300
(225) 765-5864
(225) 765-2013
Mailing address
7777 HENNESSY BLVD, ST. 701, BATON ROUGE, LA 70808-4300
(225) 765-5864
(225) 765-2013
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
200710
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02739882
—
MS
05
—
2368222
—
LA
Enumeration date
04/15/2014
Last updated
12/28/2020
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