Provider Demographics
NPI:1558379834
Name:BALDRIDGE, RUTH ELLEN (MD)
Entity type:Individual
Prefix:DR
First Name:RUTH
Middle Name:ELLEN
Last Name:BALDRIDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 DICK LONAS RD UNIT 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1383
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-381-1509
Practice Address - Street 1:7541 CROSSWOOD BLVD STE 1
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37924-3903
Practice Address - Country:US
Practice Address - Phone:865-524-1661
Practice Address - Fax:833-908-2104
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27037207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3095569OtherAETNA
TNTN01G1OtherJOHN DEERE
TN100028153OtherPHP TENNCARE
TN3373352OtherMEDICAID GRP UFP
TN1689631137OtherGROUP NPI
TN262417OtherBLACK LUNG
TN01-40110OtherUHC
TN3373352OtherMEDICARE GRP UFP
TN4284679OtherCIGNA
TN3095566Medicaid
TN3129740OtherBLUE CROSS/BLUE SHIELD
TN080145236Medicare ID - Type UnspecifiedRAILROAD
TN1689631137OtherGROUP NPI
TN262417OtherBLACK LUNG