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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679524243 NPPES
Wisconsin MEDICAID 1679524243

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