Ethridge, Chris Phillip

Ethridge, Chris Phillip is an individual health care provider with primary practice located at 1325 E Fortification St , Jackson MS 39202-2442. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hand Surgery, which is considered as his primary health care specialty. Ethridge, Chris Phillip can be contacted via phone (601) 354-4488.

Contact Information

Primary practice address
1325 E Fortification St Jackson MS 39202-2442
Phone: (601) 354-4488
Fax: (601) 914-5188
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hand Surgery 207XS0106X 8332 Mississippi

Profile Details

NPI number 1386632560
LBN Legal business name Ethridge, Chris Phillip
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2005
Last updated Nov 17th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386632560 NPPES
Mississippi Other P00100821 MEDICARE RR
Mississippi MEDICAID 00011435 MEDICARE RR

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