Pridgett, Tara Denise

Pridgett, Tara Denise is an individual health care provider with primary practice located at 3500 Sw 6Th Ave , Topeka KS 66606-2806. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Pridgett, Tara Denise can be contacted via phone (785) 235-0335.

Contact Information

Primary practice address
3500 Sw 6Th Ave Topeka KS 66606-2806
Phone: (785) 235-0335
Fax: (785) 235-0368
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 04-28519 Kansas

Profile Details

NPI number 1013929934
LBN Legal business name Pridgett, Tara Denise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013929934 NPPES
Kansas Other 058735 BLUE CROSS BLUE SHIELD
Kansas Other 337170 BLUE CROSS BLUE SHIELD
Kansas MEDICAID 100370990A BLUE CROSS BLUE SHIELD

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