Richard Thomas Ethridge MD

NPI 1013108299 - Surgery - 2086S0122X

NPI Details
NPI 1013108299
Gender Male
Enumeration Date 08/05/2007
Last Updated 01/26/2010
Entity Type Individual
Active Over 9 years ago
Practice Location
1622 8TH AVE
SUITE 130
FORT WORTH TX, 76104-4154, US
Phone (817) 921-5566
Fax (817) 921-5567
Business Location
1622 8TH AVE
SUITE 130
FORT WORTH TX, 76104-4154, US
Phone (817) 921-5566
Fax (817) 921-5567
Toxanomy
Taxonomy Code 2086S0122X
License State Texas
License Number M5152
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According to our database, Dr. Richard Thomas Ethridge MD NPI is 1013108299, taxonomy code is 2086S0122X and license number is M5152, license state is located at Texas. Richard Thomas Ethridge MD physically located at 1622 8th Ave, Fort Worth TX, 76104-4154. NPI Number Richard Thomas Ethridge MD has the Individual type.

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1013108299 NPI number is provided on an as is basis without warranty of any kind. 1013108299 is maintained by the National Plan & Provider Enumeration System. The contents of Richard Thomas Ethridge MD are for informational purposes only.