Otis B. Ferguson III MD PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

066409 Issued in MI

Legal business name

OTIS B. FERGUSON III MD PC

Practice address

7633 East Jefferson
Suite 120
Detroit, MI 48214

Phone

(313) 824-8941

Fax

(313) 824-1115

NPI assigned

Oct 4, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Otis Ferguson, MDNPI 1215013297

Title

Administrator

Phone

(313) 824-8941

Specialties & licenses 1

Addresses

Other names 1

• Consultants in Opthamology PC Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Otis B Ferguson III, MD

  • Ophthalmology Physician
  • Detroit, MI
  • NPI 1215013297
  Medicare reassignment Care Compare group NPD Authorized official
• Simone Elaine Ferguson, MD

  • Ophthalmology Physician
  • Detroit, MI
  • NPI 1932606951
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1780779678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7633 EAST JEFFERSON",
            "address_2": "SUITE 120",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48214",
            "telephone_number": "313-824-8941",
            "fax_number": "313-824-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7633 EAST JEFFERSON",
            "address_2": "SUITE 120",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48214",
            "telephone_number": "313-824-8941",
            "fax_number": "313-824-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTIS B. FERGUSON III MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "OTIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "313-824-8941",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "066409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Consultants in Opthamology PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiwalola Olufunke Osunfisan, M.D
• Rebecca Oswald, BSN, RN
• Otd Global. LLC
• Karen Barcenilla Oteyza, M.D.
• Mahmoud Othman, MD
• Otis Leon Crawford Jr
• Otto Bock Patient Care, LLC
• Otto Bock Patient Care, LLC
• Sarah E Ottum
• Takahiro Ouchi, MD

• Ophthalmology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.