Ethridge, Clarisse P
Ethridge, Clarisse P is an individual health care provider with primary practice located at 1821 S Stoughton Rd , Madison WI 53716-2257. She recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as her primary health care specialty. Ethridge, Clarisse P can be contacted via phone (608) 260-6000.Contact Information
Primary practice address
1821 S Stoughton Rd
Madison WI 53716-2257
Phone: (608) 260-6000
Fax: (608) 260-6595
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism | 207RE0101X | 36964-020 | Wisconsin |
Profile Details
| NPI number | 1679524243 |
|---|---|
| LBN Legal business name | Ethridge, Clarisse P |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2006 |
| Last updated | Jan 11th, 2022 - about 2 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 | 1679524243 | NPPES |
| Wisconsin | MEDICAID | 1679524243 |
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