James D. Ferguson Od PC
Eyewear Supplier (Equipment, not the service) in East Chicago, IN. Organization (NPI-2).
NPI number1114101912
StatusActive
Last updated in NPPESOct 13, 2010
Details
- NPI
- 1114101912
- Entity type
- Organization (NPI-2)
- Legal business name
- James D. Ferguson Od PC
- Organization subpart
- No
- Enumeration date
- Dec 28, 2007
- Last updated
- Oct 13, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier (Equipment, not the service) | 18002583A | IN | Yes |
Practice location
1820 E Columbus DrEast Chicago, IN 46312-2826
Phone 219-398-2020 · Fax 291-398-9808
Mailing address
8417 Kennedy AveHighland, IN 46322-1139
Phone 219-838-2020 · Fax 219-838-0454
Authorized official
Debra Smith
Billing Manager
2199720904
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