Individual
MICHAEL JOE RIDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
306 HIGHWAY 641 N, CAMDEN, TN 38320-3012
(731) 584-1523
(731) 986-0011
Mailing address
PO BOX 25, HUNTINGDON, TN 38344-0025
(731) 986-2213
(731) 986-0011
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1373
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3380640
—
TN
01
—
PA1373
MEDICAL LICENSE NUMBER
TN
Enumeration date
08/22/2006
Last updated
08/26/2016
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