Ethridge, Jesse C

Ethridge, Jesse C is an individual health care provider with primary practice located at 501 Marshall Street Suite 400, Jackson MS 39202-1687. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Ethridge, Jesse C can be contacted via phone (601) 354-0869.

Contact Information

Primary practice address
501 Marshall Street Suite 400 Jackson MS 39202-1687
Phone: (601) 354-0869
Fax: (601) 352-6521
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 12438 Mississippi

Profile Details

NPI number 1043263841
LBN Legal business name Ethridge, Jesse C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Nov 19th, 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 1043263841 NPPES
Mississippi MEDICAID 0011229

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