Provider Demographics
NPI:1538177076
Name:RIDINGS, ERIC O (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:O
Last Name:RIDINGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 E PIKES PEAK AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COLORADO SPGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3648
Mailing Address - Country:US
Mailing Address - Phone:719-636-3333
Mailing Address - Fax:719-636-0025
Practice Address - Street 1:455 E PIKES PEAK AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:COLORADO SPGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3648
Practice Address - Country:US
Practice Address - Phone:719-636-3333
Practice Address - Fax:719-636-0025
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35179208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC801060Medicare PIN
COF56763Medicare UPIN