Ferguson, Derrick T
Ferguson, Derrick T is an individual health care provider with primary practice located at 2651 E Discovery Pkwy , Bloomington IN 47408-9059. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Ferguson, Derrick T can be contacted via phone (812) 331-3400.Contact Information
Primary practice address
2651 E Discovery Pkwy
Bloomington IN 47408-9059
Phone: (812) 331-3400
Fax: (812) 332-7265
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 02007001A | Indiana |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 5101023275 | Michigan |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 02007001A | Indiana |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 02007001A | Indiana |
Profile Details
| NPI number | 1134656853 |
|---|---|
| LBN Legal business name | Ferguson, Derrick T |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 12th, 2017 |
| Last updated | Oct 18th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134656853 | NPPES |
| Indiana | MEDICAID | 300078836 | |
| Indiana | Other | 090540882 |
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