Dr. Richard Thomas Ethridge
Plastic and Reconstructive Surgery
1100 Poudre River Dr Unit A
Fort Collins
, Colorado 80524-3557
Dr. Richard Thomas Ethridge
Plastic and Reconstructive Surgery
1100 Poudre River Dr Unit A
Fort Collins
, Colorado 80524-3557
(970) 484-3036
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About
Features
Specialties
- Plastic and Reconstructive Surgery
Languages spoken
- English
Location
First Address
- Dr. Richard Thomas Ethridge
- 151 Southhall Ln Ste 300
- Maitland, FL
- Zip : 32751-7172
- Fax : (970) 484-3036
- Phone : (970) 484-6303
Second Address
- Dr. Richard Thomas Ethridge
- 1100 Poudre River Dr Unit A
- Fort Collins, CO
- Zip : 80524-3557
- Fax : (704) 843-0369
- Phone : (970) 484-6303
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0122X | Plastic and Reconstructive Surgery | DR.0063642 | CO |
| N | 2086S0122X | Plastic and Reconstructive Surgery | M5152 | TX |
National Provider Identifier
| NPI | 1013108299 |
|---|---|
| Provider Name | Dr. Richard Thomas Ethridge |
| First Address | Maitland, FL 32751-7172 |
| Second Address | Fort Collins, CO 80524-3557 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/08/2007 |
| Last Update Date | 23/01/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 768289543 | MYUTMB 768289543 (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.