Provider Demographics
NPI:1083697700
Name:ELDRIDGE, STUART A (MD)
Entity Type:Individual
Prefix:MR
First Name:STUART
Middle Name:A
Last Name:ELDRIDGE
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 1:800 HIGHLANDER POINT DR
Mailing Address - Street 2:STE 300
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-9465
Mailing Address - Country:US
Mailing Address - Phone:812-923-4106
Mailing Address - Fax:812-923-4100
Practice Address - Street 1:800 HIGHLANDER POINT DR
Practice Address - Street 2:STE 300
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119-9465
Practice Address - Country:US
Practice Address - Phone:812-923-4106
Practice Address - Fax:812-923-4100
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01041833208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100327230AMedicaid
F80638Medicare UPIN
IN243940BMedicare ID - Type Unspecified