Ricketts, Edward A
Ricketts, Edward A is an sole proprietor health care provider with primary practice located at 600 Nw 11Th St Suite109, Hermiston OR 97838-8602. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Ricketts, Edward A can be contacted via phone (541) 567-5075.Contact Information
Primary practice address
600 Nw 11Th St Suite109
Hermiston OR 97838-8602
Phone: (541) 567-5075
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD18739 | Oregon |
Profile Details
| NPI number | 1215079710 |
|---|---|
| LBN Legal business name | Ricketts, Edward A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 12th, 2007 |
| Last updated | Sep 28th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215079710 | NPPES |
| Oregon | MEDICAID | 060595 |
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