Individual
DR. IVAN E FERGUSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2630 NE VIVION ROAD, KANSAS CITY, MO 64119-2513
(816) 459-7175
(816) 459-7686
Mailing address
4630 TROOST AVE, KANSAS CITY, MO 64110-1712
(816) 931-8337
(816) 931-4980
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
042199
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982619904
—
MO
Enumeration date
10/19/2011
Last updated
08/13/2020
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