Ken O Ridgeway, DO is a
Family Medicine physician based in Greentown, Indiana. Ken O Ridgeway is licensed to practice in Indiana (license number 2000340) and his current practice location is 712 W Main St, Greentown, Indiana. He can be reached at his office (for appointments etc.) via phone at
(765) 628-3319.
NPI number for Ken O Ridgeway is 1013998723 and his current mailing address is 712 W Main St, Greentown, Indiana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1013998723.
Physician's Profile
| Full Name | Ken O Ridgeway |
|---|
| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 712 W Main St, Greentown, Indiana |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1013998723
- Provider Enumeration Date: 11/09/2005
- Last Update Date: 10/24/2007
Medical Identifiers
Medical identifiers for Ken O Ridgeway such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013998723 | NPI | - | NPPES |
| 100186930A | Medicaid | IN | |
| 000000183513 | Other | | ANTHEM |
| 10825830 | Other | | CAQH |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 2000340 (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ken O Ridgeway is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ken O Ridgeway, DO
712 W Main St,
Greentown, IN 46936-1045
Ph: (765) 628-3319 | Ken O Ridgeway, DO
712 W Main St,
Greentown, IN 46936-1045
Ph: (765) 628-3319 |
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