Provider Demographics
NPI:1982723417
Name:FERGUSON, RHEYDENE S (DO)
Entity type:Individual
Prefix:
First Name:RHEYDENE
Middle Name:S
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 E 2ND ST # 356
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-5313
Mailing Address - Country:US
Mailing Address - Phone:405-888-0830
Mailing Address - Fax:
Practice Address - Street 1:921 NE 13TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5007
Practice Address - Country:US
Practice Address - Phone:405-456-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3571204D00000X, 171100000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No171100000XOther Service ProvidersAcupuncturist
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine