Individual
TYLER J. ETHERIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2880 UNIVERSITY AVE, MADISON, WI 53705-3644
(608) 263-7171
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
(608) 263-7171
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
12403679-1205
UT
207W00000X
Ophthalmology Physician
Primary
83222-20
WI
Other
Enumeration date
03/31/2020
Last updated
06/06/2024
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