Provider Demographics
NPI:1780778142
Name:FERGESON, CHARLES ARTHUR JR (DC)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ARTHUR
Last Name:FERGESON
Suffix:JR
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 1:901 PACE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-1307
Mailing Address - Country:US
Mailing Address - Phone:434-447-6649
Mailing Address - Fax:434-447-6649
Practice Address - Street 1:901 PACE DR
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:VA
Practice Address - Zip Code:23970-1307
Practice Address - Country:US
Practice Address - Phone:434-447-6649
Practice Address - Fax:434-447-6649
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104 001994111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA255199OtherSOUTHERN HEALTH
VA257120OtherANTHEM BLUE CROSS
VA2241226OtherUNITED HEALTHCARE
VA7977145OtherAETNA
VA7977145OtherAETNA
VA255199OtherSOUTHERN HEALTH