Etheridge, Brian
Etheridge, Brian is an individual health care provider with primary practice located at 1007 N Pope St , Silver City NM 88061-5161. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Etheridge, Brian can be contacted via phone (575) 388-1511.Contact Information
Primary practice address
1007 N Pope St
Silver City NM 88061-5161
Phone: (575) 388-1511
Fax: (575) 313-8236
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD2007-0195 | New Mexico |
Profile Details
| NPI number | 1487767562 |
|---|---|
| LBN Legal business name | Etheridge, Brian |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 16th, 2006 |
| Last updated | Oct 3rd, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487767562 | NPPES |
| New Mexico | MEDICAID | 40906361 |
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