Basic Information
| Provider Information | |||||||||
| NPI: | 1104823434 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FERGUSON | ||||||||
| FirstName: | JOE | ||||||||
| MiddleName: | RICE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVENUE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174218 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WAYNESBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172682332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177655060 | ||||||||
| FaxNumber: | 7177655066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2005 | ||||||||
| LastUpdateDate: | 01/10/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD418761 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 25-1716306 | 01 | PA | SOUTH CENTRAL PREFERRED | OTHER | 25-1716306 | 01 | PA | MULTIPLAN/PHCS | OTHER | 50078951 | 01 | PA | CAPITAL BLUECROSS | OTHER | MD418761 | 01 | PA | LICENSE | OTHER | 120420414 | 01 | PA | DEPT OF LABOR | OTHER | 25-1716306 | 01 | PA | INFORMED | OTHER | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | BF6109575 | 01 | PA | DEA | OTHER | 1525332 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 7694509 | 01 | PA | AETNA NON-HMO | OTHER | 2179950 | 01 | PA | MAMSI | OTHER | 25-1716306 | 01 | PA | DEVON | OTHER | P00708433 | 01 | PA | RAILROAD MEDICARE | OTHER | 25-1716306 | 01 | PA | FIRST HEALTH | OTHER | 25-1716306 | 01 | PA | HEALTHNET/TRICARE | OTHER | 25-1716306 | 01 | PA | INTERGROUP | OTHER | 3369154 | 01 | PA | AETNA HMO | OTHER | 001972175 0004 | 05 | PA | MEDICAID | 1104823434 | 01 | PA | HEALTH AMERICA | OTHER | 25-1716306 | 01 | PA | GREATWEST | OTHER |