Healthcare Provider Details

I. General information

NPI: 1306872528
Provider Name (Legal Business Name): BRET D RIPLEY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1867 AMHERST ST STE 101
WINCHESTER VA
22601-2869
US

IV. Provider business mailing address

1867 AMHERST ST STE 101
WINCHESTER VA
22601-2869
US

V. Phone/Fax

Practice location:
  • Phone: 540-667-8724
  • Fax: 540-662-5638
Mailing address:
  • Phone: 540-667-8724
  • Fax: 540-662-5638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34006392
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02853
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO-04444
License Number StateIA
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102201949
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: