Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | DPM487 | TN |
Y | 222Z00000X | Podiatrist | DPM487 | TN |
NPI | 1043296593 |
---|---|
Provider Name | Dr. Kendale L Ritchey |
First Address | Knoxville, TN 37930-2569 |
Second Address | Knoxville, TN 37923-4330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2005 |
Last Update Date | 01/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3352563 | (05) | TN |
480026875 | RAILROAD MEDICARE (01) | TN |
U61809 | (02) |