Provider Demographics
NPI:1790732725
Name:RIDINGS, EDWARD HASLAM III (DO)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:HASLAM
Last Name:RIDINGS
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:310 ELECTRIC AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-1369
Mailing Address - Country:US
Mailing Address - Phone:717-248-7512
Mailing Address - Fax:717-248-2710
Practice Address - Street 1:310 ELECTRIC AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1369
Practice Address - Country:US
Practice Address - Phone:717-248-7512
Practice Address - Fax:717-248-2710
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS003806L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008437180002Medicaid
PAVA412988Medicare ID - Type Unspecified