Provider Demographics
NPI:1861694671
Name:ROBERT G. FERLAND, M.D. PC
Entity type:Organization
Organization Name:ROBERT G. FERLAND, M.D. PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:GUY
Authorized Official - Last Name:FERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-384-9690
Mailing Address - Street 1:2102 PARK PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-3937
Mailing Address - Country:US
Mailing Address - Phone:615-384-9690
Mailing Address - Fax:615-384-9947
Practice Address - Street 1:2102 PARK PLAZA DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-3937
Practice Address - Country:US
Practice Address - Phone:615-384-9690
Practice Address - Fax:615-384-9947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN=========OtherTAX IDENTIFICATION NUMBER