Healthcare Provider Details

I. General information

NPI: 1023070711
Provider Name (Legal Business Name): JAMES THOMAS RITTELMEYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 07/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N 18TH ST STE 100
MONROE LA
71201-5712
US

IV. Provider business mailing address

1100 N 18TH ST STE 100
MONROE LA
71201-5712
US

V. Phone/Fax

Practice location:
  • Phone: 318-361-9900
  • Fax: 318-361-0428
Mailing address:
  • Phone: 318-361-9900
  • Fax: 318-361-0428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101043891
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD.208039
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD.208039
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number0101043891
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: