Search › Alaska › 363A00000X
Timothy Ethridge, PA-C
NPI 1457911471 · on the registry since 2019 · sole proprietor
Practice
- Address
- 5955 Zeamer Ave
Anchorage, AK 99506 - Phone
- (907) 580-1711
- Fax
- (111) 111-1111
- Organisation at this address
- Department Of Defense
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 76
Additional practice sites
- 500 Fisher St, Biloxi, MS
- 243 Curtiss Rd Ste 100, Barksdale Afb, LA
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 363AM0700X
390200000X - Licence states on file
- NULL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-07-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Alaska