Provider Demographics
NPI:1306986161
Name:FERGUSON, DELWEYN SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:DELWEYN
Middle Name:SCOTT
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 N FAIRFIELD RD STE B
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45432-2654
Mailing Address - Country:US
Mailing Address - Phone:937-426-0777
Mailing Address - Fax:888-551-1489
Practice Address - Street 1:1360 N FAIRFIELD RD STE B
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45432-2654
Practice Address - Country:US
Practice Address - Phone:937-426-0777
Practice Address - Fax:888-551-1489
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3008111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0007418215OtherAETNA
OH2217167Medicaid
OHANTHEM BCBSOther000000195483
OH0007418215OtherAETNA
OH0007418215OtherAETNA
OH2217167Medicaid