William Bruce Ethridge, MD

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

License

12956 Issued in AZ

Practice address

1951 W 25TH Street
Ste F
Yuma, AZ 85364

Phone

(928) 314-1174

Fax

(928) 314-1175

NPI assigned

Apr 13, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Arizona Oncology Services of Yuma

  • Radiation Oncology Physician
  • Phoenix, AZ
  • NPI 1922203728
  NPD (past)
• Giangreco Medical Group

  • Medical Oncology Physician
  • Yuma, AZ
  • NPI 1174550412
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1205890530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2332",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "92263",
            "telephone_number": "760-322-1205",
            "fax_number": "760-778-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 W 25TH STREET",
            "address_2": "STE F",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "85364",
            "telephone_number": "928-314-1174",
            "fax_number": "928-314-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHRIDGE",
        "first_name": "WILLIAM",
        "middle_name": "BRUCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "AZ",
            "license": "12956",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "AZ",
            "license": "12956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "249145",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adrian Joseph Estrada, FNP-C
• Fernando Estrada, LCSW
• Kaylah Daniella Shanell Estrada
• Sol Alina Estrada I
• Eternity Home Health of Yuma LLC
• Evangelista Medical Group, PC
• Adelbert Evangelista, MD
• Jemylene Ronsayro Evangelista, M.D.
• Charles W Evans, FOSTER PARENT
• Devon Zenobia Evans, R.N.

• Medical Oncology Physician in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Medical Oncology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.