Ken O Ridgeway DO

NPI 1013998723 - Family Medicine - 207Q00000X

NPI Details
NPI 1013998723
Gender Male
Enumeration Date 11/09/2005
Last Updated 10/24/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
712 W MAIN ST
GREENTOWN IN, 46936-1045, US
Phone (765) 628-3319
Fax (765) 628-5979
Business Location
712 W MAIN ST
GREENTOWN IN, 46936-1045, US
Phone (765) 628-3319
Fax (765) 628-5979
Toxanomy
Taxonomy Code 207Q00000X
License State Indiana
License Number 2000340
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According to our database, Ken O Ridgeway DO NPI is 1013998723, taxonomy code is 207Q00000X and license number is 2000340, license state is located at Indiana. Ken O Ridgeway DO physically located at 712 W Main St, Greentown IN, 46936-1045. NPI Number Ken O Ridgeway DO has the Individual type.

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1013998723 NPI number is provided on an as is basis without warranty of any kind. 1013998723 is maintained by the National Plan & Provider Enumeration System. The contents of Ken O Ridgeway DO are for informational purposes only.