Ridley, Michael Joe

Ridley, Michael Joe is an individual health care provider with primary practice located at 306 Highway 641 N , Camden TN 38320-3012. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Ridley, Michael Joe can be contacted via phone (731) 584-1523.

Contact Information

Primary practice address
306 Highway 641 N Camden TN 38320-3012
Phone: (731) 584-1523
Fax: (731) 986-0011
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA1373 Tennessee

Profile Details

NPI number 1023124161
LBN Legal business name Ridley, Michael Joe
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2006
Last updated Aug 26th, 2016 - about 10 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 1023124161 NPPES
Tennessee MEDICAID 3380640
Tennessee Other PA1373

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