Individual
GARY R RIDGE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
157 N 400 W, OREM, UT 84057-1909
(801) 226-2421
(801) 226-3869
Mailing address
157 N 400 W, OREM, UT 84057-1909
(801) 226-2421
(801) 226-3869
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
1034600501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0761150001
CIGNA MEDICARE
UT
01
—
107006243102
SELECT HEALTH
UT
01
—
19925
DESERET MUTUAL
UT
01
—
2365
PUBLIC EMPLOYEES HEALTH
UT
01
—
270510
ALTIUS HEALTH PLANS
UT
05
—
E0110
—
UT
Enumeration date
05/31/2006
Last updated
07/08/2007
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