Provider Demographics
NPI:1245221753
Name:FERGUSON, DAVID ROYCE (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROYCE
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 US HIGHWAY 27 S
Mailing Address - Street 2:
Mailing Address - City:CYNTHIANA
Mailing Address - State:KY
Mailing Address - Zip Code:41031-9603
Mailing Address - Country:US
Mailing Address - Phone:859-234-2044
Mailing Address - Fax:859-234-2044
Practice Address - Street 1:3106 US HIGHWAY 27 S
Practice Address - Street 2:
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-9603
Practice Address - Country:US
Practice Address - Phone:859-234-2044
Practice Address - Fax:859-234-2044
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4337111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYU62323Medicare UPIN