Individual provider · Type 1 NPI

Kelly R. Ridge, PAC

Surgical Physician Assistant · Brockton, MA

NPI number 1992789739 Active

Practice location

680 Centre St
Brockton, MA 02302-3308

Call (508) 941-7000 Map

Mailing address

3 Washington St, Ste 200
North Easton, MA 02356-1010

Other practice locations

  • 3 Washington St, Ste 200, North Easton, MA 02356-1010 · (508) 205-9630

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X1104 (MA)

Surgical Physician Assistant: Definition to come...

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About NPI 1992789739

Kelly R. Ridge, PAC's National Provider Identifier is 1992789739, issued on Dec 5, 2005. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Brockton, MA. The record was last updated on Feb 10, 2025.