Search › Georgia › 163W00000X
Jerry Ethridge
NPI 1851259105 · on the registry since 2026 · sole proprietor
Practice
- Address
- 820 Ashley Laine Walk
Lawrenceville, GA 30043 - Phone
- (229) 392-3459
Registry record
- Primary taxonomy
- 163W00000X
163W00000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-01-14
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 Georgia