Ferguson, Jill Anne

Ferguson, Jill Anne is an individual health care provider with primary practice located at 2915 Missouri Ave , Shreveport LA 71109-4327. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Ferguson, Jill Anne can be contacted via phone (318) 621-8820.

Contact Information

Primary practice address
2915 Missouri Ave Shreveport LA 71109-4327
Phone: (318) 621-8820
Fax: (318) 212-4189
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 11013817A Indiana
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 205414 Louisiana

Profile Details

NPI number 1093975039
LBN Legal business name Ferguson, Jill Anne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2008
Last updated Jun 22nd, 2016 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093975039 NPPES
Louisiana Other MD.205414 LA - STATE LICENSE MD
Louisiana Other 12373627 LA - STATE LICENSE MD
Louisiana Other P01099769 LA - STATE LICENSE MD
Louisiana MEDICAID 2302086 LA - STATE LICENSE MD

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