NPI 1164528329

Elizabeth Wilson Ridgway, MD

Practitioner Pediatrics Physician Jackson, WY

Practice location

Address: 557 East Broadway, Jackson, WY 83001
Phone: (307) 733-4627
Fax: (307) 733-5184
Mailing address: PO Box 1029 557 E. Broadway, Jackson, WY 83001-1029

Registered specialties (2)

Pediatrics Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208000000X Licence 2241-A (WY)

Other Pediatrics providers in Wyoming →

Pediatrics Physician

Allopathic & Osteopathic Physicians Taxonomy 208000000X Licence M-8159 (ID)

Registry record

NPI: 1164528329
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Sep 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.