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General NPI Number Information
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NPI Number | 1639749401
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Entity Type | Individual
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Provider Name | LOGAN EUGENE RITCHHART
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Gender | Male
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Dates
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Enumeration Date | 06/25/2021
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 305 MAIN ST
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City | BROOKVILLE
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State | IN
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Zip | 47012-1363
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Country | US
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Telephone | 765-547-1325
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Fax | 765-547-1327
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Provider Business Mailing Address
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Address Line | PO BOX 297
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42719-0297
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Country | US
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Telephone | 270-469-4393
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Fax | 270-469-1050
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18004615
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License Number State | IN
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