Individual
MS. ELIZABETH WILSON RIDGWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
557 EAST BROADWAY, JACKSON, WY 83001
(307) 733-4627
(307) 733-5184
Mailing address
PO BOX 1029, 557 E. BROADWAY, JACKSON, WY 83001-1029
(307) 733-4627
(307) 733-5184
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2241-A
WY
208000000X
Pediatrics Physician
M-8159
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10452700
—
WY
Enumeration date
09/15/2006
Last updated
07/08/2007
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