Basic Information
Provider Information
NPI: 1285614222
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIDINGS
FirstName: JANE
MiddleName: WITTER
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1425 N UNION BLVD
Address2: SUITE 202
City: COLORADO SPRINGS
State: CO
PostalCode: 809092871
CountryCode: US
TelephoneNumber: 7195707675
FaxNumber: 7194719314
Practice Location
Address1: 525 N FOOTE AVE
Address2:  
City: COLORADO SPRINGS
State: CO
PostalCode: 809094554
CountryCode: US
TelephoneNumber: 7193656800
FaxNumber: 7194719314
Other Information
ProviderEnumerationDate: 01/17/2006
LastUpdateDate: 01/07/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001X35122COY Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

No ID Information.


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