Basic Information
| Provider Information | |||||||||
| NPI: | 1407049083 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DANIEL R. FERGUSON, MD, P.C. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BRIGHAM CENTER FOR WOMEN'S HEALTH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 984 MEDICAL DR | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | BRIGHAM CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 843024712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4356952273 | ||||||||
| FaxNumber: | 4356952278 | ||||||||
| Practice Location | |||||||||
| Address1: | 984 MEDICAL DR | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | BRIGHAM CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 843024712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4356952273 | ||||||||
| FaxNumber: | 4356952278 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2007 | ||||||||
| LastUpdateDate: | 08/27/2007 | ||||||||
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| AuthorizedOfficialLastName: | FERGUSON | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | PROPRIETOR | ||||||||
| AuthorizedOfficialTelephone: | 4356952273 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 5039763-1205 | UT | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.