Individual
JEFFREY H FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10603 N MERIDIAN ST, INDIANAPOLIS, IN 46290-1055
(317) 415-6050
Mailing address
8840 COMMERCE PARK PL STE E, INDIANAPOLIS, IN 46268-3129
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01024850A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100057860
—
IN
Enumeration date
02/15/2006
Last updated
11/05/2014
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