Ethridge, Jeff D
Ethridge, Jeff D is an individual health care provider with primary practice located at 805 Kelly Creek Rd , Bulverde TX 78163-3035. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Ethridge, Jeff D can be contacted via phone (830) 980-1805.Contact Information
Primary practice address
805 Kelly Creek Rd
Bulverde TX 78163-3035
Phone: (830) 980-1805
Fax: (830) 438-5662
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | L6877 | Texas |
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 207QH0002X | L6877 | Texas |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | L6877 | Texas |
Profile Details
| NPI number | 1154318095 |
|---|---|
| LBN Legal business name | Ethridge, Jeff D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2005 |
| Last updated | Aug 21st, 2020 - about 4 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 | 1154318095 | NPPES |
| Texas | MEDICAID | 167684801 | |
| Texas | MEDICAID | 167686808 |
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