Individual
DR. JOHN P ELDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-5401
(859) 344-1600
(859) 344-0091
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 344-1600
(859) 344-0091
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
23565
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000033738
ANTHEM
KY
01
—
000000747824
ANTHEM
—
01
—
020010539
RAILROAD MEDICARE
KY
05
—
0707088
—
OH
01
—
0789943
CIGNA
—
01
—
3700184
UNITED HEALTHCARE
KY
01
—
4201976
AETNA
KY
05
—
64235658
—
KY
Enumeration date
06/10/2006
Last updated
03/18/2019
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