Provider Demographics
NPI:1700094380
Name:FERGUSON, BRYCE LYMAN (MD)
Entity type:Individual
Prefix:
First Name:BRYCE
Middle Name:LYMAN
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1380 E MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2123
Mailing Address - Country:US
Mailing Address - Phone:435-251-1606
Mailing Address - Fax:435-251-2610
Practice Address - Street 1:1380 E MEDICAL CENTER DR
Practice Address - Street 2:SUITE 2200
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2123
Practice Address - Country:US
Practice Address - Phone:435-251-1606
Practice Address - Fax:435-251-2610
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.089381207R00000X
UT8073911-1205207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease