Ethridge, Richard Thomas

Ethridge, Richard Thomas is an sole proprietor health care provider with primary practice located at 1100 Poudre River Dr Unit A , Fort Collins CO 80524-3557. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Ethridge, Richard Thomas can be contacted via phone (970) 484-6303.

Contact Information

Primary practice address
1100 Poudre River Dr Unit A Fort Collins CO 80524-3557
Phone: (970) 484-6303
Fax: (704) 843-0369
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X DR.0063642 Colorado
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X M5152 Texas

Profile Details

NPI number 1013108299
LBN Legal business name Ethridge, Richard Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 5th, 2007
Last updated Jan 23rd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013108299 NPPES
Other 768289543 MYUTMB 768289543

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