Healthcare Provider Details

I. General information

NPI: 1891829768
Provider Name (Legal Business Name): RITTMAN FAMILY PRACTICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 S MAIN ST SUITE B
RITTMAN OH
44270-1914
US

IV. Provider business mailing address

25 S MAIN ST SUITE B
RITTMAN OH
44270-1914
US

V. Phone/Fax

Practice location:
  • Phone: 330-925-3857
  • Fax: 330-925-4016
Mailing address:
  • Phone: 330-925-3857
  • Fax: 330-925-4016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35071171W
License Number StateOH

VIII. Authorized Official

Name: DR. DARRELL LEROY WIDMER
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 330-925-3857