Individual
WILLIAM BRUCE ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1951 W 25TH STREET, STE F, YUMA, AZ 85364
(928) 314-1174
(928) 314-1175
Mailing address
PO BOX 2332, PALM SPRINGS, CA 92263
(760) 322-1205
(760) 778-5770
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
12956
AZ
2085R0001X
Radiation Oncology Physician
12956
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
249145
AHCCCS
AZ
Enumeration date
04/13/2006
Last updated
02/20/2008
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