Provider Demographics
NPI:1487601860
Name:FERGUSON, JOHN F (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9434
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65801-9434
Mailing Address - Country:US
Mailing Address - Phone:417-885-3888
Mailing Address - Fax:417-881-7638
Practice Address - Street 1:2900 S NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-3634
Practice Address - Country:US
Practice Address - Phone:417-885-3888
Practice Address - Fax:417-881-7638
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO32107207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0609014OtherUNITED HEALTHCARE
MO1328OtherCOX HEALTH PLANS UPI
MO200031011Medicaid
WA0215390OtherDEPARTMENT OF LABOR WA
MO06050019500OtherQUAL CHOICE
MOA13288OtherUSPS (W/C)
MO26341OtherBLUE CROSS / CHOICE
MO283706OtherHEALTHLINK
MO6851509004OtherCIGNA HEALTHCARE
MO18942OtherCOX HEALTH PLANS
MO4188130001OtherCIGNA MEDICARE
MO1328OtherCOX HEALTH PLANS UPI
MO283706OtherHEALTHLINK
MO06050019500OtherQUAL CHOICE
MO4188130001OtherCIGNA MEDICARE
MO005013401Medicare NSC
MOMA3059006Medicare PIN