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Edrick Jordan Ferguson, MD
Diagnostic Radiology Physician in Canton, Illinois
NPI 1659365872

Edrick Jordan Ferguson is a Diagnostic Radiology Physician based in Urbana, IL and is specialized in Diagnostic Radiology. Edrick Jordan Ferguson practices in Canton, IL and has the professional credentials of MD. The NPI Number for Edrick Jordan Ferguson is 1659365872 and holds a License No. 35079693 (Illinois).

The current practice location address for Edrick Jordan Ferguson is 210 W Walnut St, Canton, IL and can be reached out via phone at 309-647-5240.

Location: 210 W Walnut St, Canton, IL, 61801-2500
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659365872
Provider Name
Edrick Jordan Ferguson
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
210 W Walnut St, Canton, IL, 61801-2500
Phone Number
309-647-5240
Fax Number
Provider Enumeration Date
09/02/2005
Last Update Date
01/18/2025
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Provider's Legacy Identifiers
Identifier Type State Issuer
1508037 05 TN
000000270956 01 OH ANTHEM
4191954 01 TN BLUE CROSS BLUE SHIELD
P00468253 01 RAILROAD MEDICARE
30885811 05 TN
2383924 05 OH
4166295 01 TN BCBS PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
210 W Walnut St
City
Canton
State
Illinois
Zip
61520-2444
Phone Number
309-647-5240
Fax Number
person
Provider Business Mailing Address Details
Address
210 W Walnut St
City
Canton
State
Illinois
Zip
61520-2444
Phone Number
309-647-5240
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
26307 (Tennessee)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
35079693 (Ohio)
Definition
Definition to come...
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