IndividualActive
Richard Ethridge, MD
NPI 1013108299 · Plastic and Reconstructive Surgery Physician · Fort Collins, CO
Provider details
- NPI number
- 1013108299
- Entity type
- Individual
- Primary specialty
- Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- DR.0063642 (CO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
1100 Poudre River Dr Unit a
Fort Collins, CO 80524-3557
Phone: (970) 484-6303
Fax: (704) 843-0369
Approximate (ZIP-level) locationGet directions
Mailing address
151 Southhall Ln Ste 300
Maitland, FL 32751-7172
Registry dates
- Enumerated
- 2007-08-05
- Last updated
- 2020-01-23
- Certified
- 2020-01-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.