Provider Demographics
NPI:1497071716
Name:RITCHIE, COLEMAN PRICE (MD)
Entity Type:Individual
Prefix:
First Name:COLEMAN
Middle Name:PRICE
Last Name:RITCHIE
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 1:6650 SW MISSION VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-5654
Mailing Address - Country:US
Mailing Address - Phone:785-272-1250
Mailing Address - Fax:
Practice Address - Street 1:6650 SW MISSION VALLEY DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-5654
Practice Address - Country:US
Practice Address - Phone:785-272-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME119877207N00000X
390200000X
KS04-38390207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS068002337OtherMEDICARE PTAN
KS201120060AMedicaid
FL012193000Medicaid
FLHW279ZMedicare PIN