Healthcare Provider Details

I. General information

NPI: 1285614222
Provider Name (Legal Business Name): JANE WITTER RIDINGS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 01/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 N FOOTE AVE
COLORADO SPRINGS CO
80909-4554
US

IV. Provider business mailing address

1425 N UNION BLVD SUITE 202
COLORADO SPRINGS CO
80909-2871
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-6800
  • Fax: 719-471-9314
Mailing address:
  • Phone: 719-570-7675
  • Fax: 719-471-9314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35122
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: