Ridgway, Elizabeth Wilson

Ridgway, Elizabeth Wilson is an individual health care provider with primary practice located at 557 East Broadway , Jackson WY 83001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Ridgway, Elizabeth Wilson can be contacted via phone (307) 733-4627.

Contact Information

Primary practice address
557 East Broadway Jackson WY 83001
Phone: (307) 733-4627
Fax: (307) 733-5184
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2241-A Wyoming
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M-8159 Idaho

Profile Details

NPI number 1164528329
LBN Legal business name Ridgway, Elizabeth Wilson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2006
Last updated Jul 8th, 2007 - about 19 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 1164528329 NPPES
Wyoming MEDICAID 10452700

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