Provider Demographics
NPI:1669682522
Name:FERGUSON, JOHN H (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 W 38TH AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4300
Mailing Address - Country:US
Mailing Address - Phone:303-940-1661
Mailing Address - Fax:303-431-8708
Practice Address - Street 1:8550 W 38TH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4300
Practice Address - Country:US
Practice Address - Phone:303-940-1661
Practice Address - Fax:303-431-8708
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-7873207R00000X
CODR-47917207R00000X
COTL-3034207R00000X
CODR47917207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP01080554OtherMEDICARE RAILROAD
TN1529909Medicaid
KY7100228280Medicaid
TN103I294444Medicare PIN