Healthcare Provider Details

I. General information

NPI: 1376926550
Provider Name (Legal Business Name): JAMES RITTELMEYER MD CARDIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 07/07/2015
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 TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD.208039
License Number StateLA

VIII. Authorized Official

Name: DR. JAMES THOMAS RITTELMEYER
Title or Position: OWNER
Credential: MD
Phone: 318-361-9900