Individual
DR. LOUIS E RIDGWAY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2817 JBS PKWY, SUITE A-103, ODESSA, TX 79762-8111
(432) 582-2277
(432) 333-2802
Mailing address
2817 JBS PKWY, SUITE A-103, ODESSA, TX 79762-8111
(432) 582-2277
(432) 333-2802
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
04-24081
KS
207VM0101X
Maternal & Fetal Medicine Physician
Primary
H4043
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100160590A
—
KS
05
—
100160590D
—
KS
05
—
100169010D
—
KS
05
—
1851367346
—
MO
05
—
206852816
—
MO
01
—
P00731935
MEDICARE RR
MO
01
—
P00740098
MEDICARE RR
MO
Enumeration date
02/24/2006
Last updated
07/28/2016
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