Ferguson, Tracy

Ferguson, Tracy is an individual health care provider with primary practice located at 4112 E Ponce De Leon Ave , Clarkston GA 30021-8106. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Ferguson, Tracy can be contacted via phone (404) 296-7133.

Contact Information

Primary practice address
4112 E Ponce De Leon Ave Clarkston GA 30021-8106
Phone: (404) 296-7133
Fax: (404) 296-7211
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 054023 Georgia

Profile Details

NPI number 1922063734
LBN Legal business name Ferguson, Tracy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Jan 13th, 2022 - about 4 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 1922063734 NPPES
Georgia MEDICAID 347582150A
Georgia MEDICAID 347582150B

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