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OTIS B. FERGUSON III MD PC NPI 1780779678


NPI Information

NPI: 1780779678
Provider Name: OTIS B. FERGUSON III MD PC

Doing Business As: CONSULTANTS IN OPTHAMOLOGY PC

Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 23D2030123

Address:
7633 EAST JEFFERSON
SUITE 120
DETROIT, MI
ZIP 48214
Phone: (313) 824-8941
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OTIS B. FERGUSON III MD PC is an ophthalmology in Detroit, MI. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. OTIS B. FERGUSON III MD PC NPI is 1780779678. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Consultants In Opthamology Pc.

The provider's business location address is:

7633 EAST JEFFERSON
SUITE 120
DETROIT, MI
ZIP 48214
Phone: (313) 824-8941
Fax: (313) 824-1115

The provider's authorized official is Otis Ferguson .
The authorized official title is Administrator and has the following contact phone number (313) 824-8941.

The CLIA number assigned to this NPI record is 23D2030123 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/4/2006 and was last updated on 3/11/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmology066409MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11169640001MEDICARE NSC
20P28580MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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