Provider Demographics
NPI:1366640153
Name:FERGUSON, ROBERT EDWARD HUGH JR (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EDWARD HUGH
Last Name:FERGUSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:801-233-4400
Mailing Address - Fax:801-233-4410
Practice Address - Street 1:5169 COTTONWOOD ST
Practice Address - Street 2:SUITE 410
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6767
Practice Address - Country:US
Practice Address - Phone:801-507-1650
Practice Address - Fax:801-233-4410
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT6964260-1205208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery