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R D FERGUSON DO PC NPI 1417136425


NPI Information

NPI: 1417136425
Provider Name: R D FERGUSON DO, PC

Doing Business As: LITTLE TRAVERSE BAY FAMILY MEDICINE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
2390 MITCHELL PARK DR
UNIT C
PETOSKEY, MI
ZIP 49770
Phone: (231) 348-1968
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R D FERGUSON DO, PC is a family medicine in Petoskey, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. R D FERGUSON DO, PC NPI is 1417136425. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Little Traverse Bay Family Medicine.

The provider's business location address is:

2390 MITCHELL PARK DR
UNIT C
PETOSKEY, MI
ZIP 49770-965
Phone: (231) 348-1968
Fax: (231) 348-1969

The provider's authorized official is Teresa G Hudson .
The authorized official title is Billing Manager and has the following contact phone number (231) 487-1141.

The enumeration date for this NPI number is 10/25/2007 and was last updated on 11/7/2007.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine5101012069MICHIGANYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10P27000MEDICARE UPINMICHIGAN
24830173MEDICAIDMICHIGAN

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: 5/5/2024

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