Provider Demographics
NPI:1407949894
Name:RITCHER, GEORGE ALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ALBERT
Last Name:RITCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NICK
Other - Middle Name:
Other - Last Name:RITCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2243 MAIN AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-4699
Mailing Address - Country:US
Mailing Address - Phone:970-259-9052
Mailing Address - Fax:970-259-0670
Practice Address - Street 1:2243 MAIN AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4699
Practice Address - Country:US
Practice Address - Phone:970-259-9052
Practice Address - Fax:970-259-0670
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18552174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00011957Medicaid
CO91812966Medicaid
NM00005009Medicaid
NM00011957Medicaid
CO91812966Medicaid