# DR. JOHN KENDALL ETHRIDGE JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1306042619
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 25614 | OK | — |
| 207VM0101X | Maternal & Fetal Medicine Physician | 2018009510 | MO | Yes |
| 207VM0101X | Maternal & Fetal Medicine Physician | 51003 | TN | — |

## Other

- **Enumeration date:** 06/23/2007
- **Last updated:** 07/10/2018