Basic Information
Provider Information
NPI: 1811257850
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FERGUSON
FirstName: JAMES
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 455 TOLL GATE RD
Address2:  
City: WARWICK
State: RI
PostalCode: 028862759
CountryCode: US
TelephoneNumber: 4017377010
FaxNumber: 4017364546
Practice Location
Address1: 1407 S COUNTY TRL STE 430A
Address2:  
City: EAST GREENWICH
State: RI
PostalCode: 028181679
CountryCode: US
TelephoneNumber: 4018867910
FaxNumber: 4018867913
Other Information
ProviderEnumerationDate: 05/24/2012
LastUpdateDate: 12/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XMD14925RIY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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