Ricketts, Robert

Ricketts, Robert is an individual health care provider with primary practice located at 3150 N 12Th St , Grand Junction CO 81506-2863. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ricketts, Robert can be contacted via phone (970) 245-1220.

Contact Information

Primary practice address
3150 N 12Th St Grand Junction CO 81506-2863
Phone: (970) 245-1220
Fax: (970) 254-2398
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 45606 Colorado

Profile Details

NPI number 1720069123
LBN Legal business name Ricketts, Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 11th, 2005
Last updated Aug 5th, 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 1720069123 NPPES
Colorado MEDICAID 72854065

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