| 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 | 29 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 |
| 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 |