DESTINY ETHERIDGE, MD

Family Medicine

Active Individual
NPI: 1871099002

Practice Address

1720 W BROADWAY STE 107
Louisville, KY 40203

Phone: (502) 340-5900

Specialties

Specialty Code Primary License
Family Medicine 207Q00000X Yes 55932 (KY)
Family Medicine - Addiction Medicine 207QA0401X No 55932 (KY)

Frequently Asked Questions

NPI 1871099002 is the National Provider Identifier for DESTINY ETHERIDGE, MD, a Family Medicine provider located in Louisville, KY. This NPI was enumerated on April 5, 2018.
DESTINY ETHERIDGE, MD practices at 1720 W BROADWAY STE 107, Louisville, KY 40203.

Quick Facts

NPI
1871099002
Type
Individual
Enumerated
Apr 5, 2018
Last Updated
Aug 8, 2022

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