Provider Demographics
NPI:1700030251
Name:RITCHIE, THOMAS ALLAN (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALLAN
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 1:5525 E LINCOLN DR
Mailing Address - Street 2:#125
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-4119
Mailing Address - Country:US
Mailing Address - Phone:928-300-9886
Mailing Address - Fax:
Practice Address - Street 1:5525 E LINCOLN DR
Practice Address - Street 2:#125
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-4119
Practice Address - Country:US
Practice Address - Phone:928-300-9886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL03607223207LP2900X, 208D00000X
IL0360722232083P0901X
AZ166752083P0901X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine