Provider Demographics
NPI:1942888730
Name:RITCHEY, GREGORY PAUL (DPM)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:PAUL
Last Name:RITCHEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:742 MOUNT VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43203-1405
Mailing Address - Country:US
Mailing Address - Phone:440-313-4449
Mailing Address - Fax:
Practice Address - Street 1:680 BUCKLES CT N STE 2A
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-6928
Practice Address - Country:US
Practice Address - Phone:614-446-8175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH36.004159213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program