Provider Demographics
NPI:1578671996
Name:ALDRIDGE, JEFFREY H
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:H
Last Name:ALDRIDGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2493
Mailing Address - Country:US
Mailing Address - Phone:828-274-4880
Mailing Address - Fax:651-646-5144
Practice Address - Street 1:393 N DUNLAP STREET
Practice Address - Street 2:832
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104
Practice Address - Country:US
Practice Address - Phone:651-646-2717
Practice Address - Fax:651-646-5144
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN26540208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN620808800Medicaid