Tricia L Etheridge, MD | |
109 S Green St, Ridgeland, SC 29936-9165 | |
(843) 726-6773 | |
(843) 726-6778 |
Full Name | Tricia L Etheridge |
---|---|
Gender | Female |
Speciality | Family Practice |
Experience | 28 Years |
Location | 109 S Green St, Ridgeland, South Carolina |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366531162 | NPI | - | NPPES |
320114664 | Other | SC | BLUE CROSS BLUE SHIELD |
42D1028556 | Other | SC | CLIA |
DC4084 | Other | SC | RAIL ROAD MEDICARE |
320114664 | Other | SC | TAX ID |
19547 | Other | SC | LICENSE # |
L25587 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 19547 (South Carolina) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Amedisys Home Health Of Beaufort | Ladys island, SC | Home health agency |
Kindred At Home | Walterboro, SC | Home health agency |
St Joseph's Hospital - Savannah | Savannah, GA | Hospital |
Candler Hospital | Savannah, GA | Hospital |
Coastal Carolina Hospital | Hardeeville, SC | Hospital |
Beaufort County Memorial Hospital | Beaufort, SC | Hospital |
Hampton Regional Medical Center | Varnville, SC | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Sjc Medical Group Inc | 7719978105 | 49 |
Entity Name | Sjc Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1811233828 PECOS PAC ID: 7719978105 Enrollment ID: O20130702000782 |
Mailing Address | Practice Location Address |
---|---|
Tricia L Etheridge, MD 109 S Green St, Ridgeland, SC 29936-9165 Ph: (843) 726-6773 | Tricia L Etheridge, MD 109 S Green St, Ridgeland, SC 29936-9165 Ph: (843) 726-6773 |
Mr. Chatchaval Vuthiganon, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 1506 Grays Highway, Suite C, Ridgeland, SC 29936 Phone: 843-726-4527 |