Individual provider · Type 1 NPI
Richard Thomas Ethridge, MD
Plastic and Reconstructive Surgery Physician · Fort Collins, CO
NPI number
1013108299
Active
Practice location
1100 Poudre River Dr Unit A
Fort Collins, CO 80524-3557
Fax (704) 843-0369
Mailing address
151 Southhall Ln Ste 300
Maitland, FL 32751-7172
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Plastic and Reconstructive Surgery Physician Primary | 2086S0122X | DR.0063642 (CO) |
| Plastic and Reconstructive Surgery Physician | 2086S0122X | M5152 (TX) |
Plastic and Reconstructive Surgery Physician: A surgeon who specializes in plastic and reconstructive surgery.
2 other providers at this address
Other plastic and reconstructive surgery physician providers in Fort Collins
About NPI 1013108299
Richard Thomas Ethridge, MD's National Provider Identifier is 1013108299, issued on Aug 5, 2007. The primary taxonomy on file is Plastic and Reconstructive Surgery Physician (2086S0122X), and the practice location is in Fort Collins, CO. The record was last updated on Jan 23, 2020.