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General NPI Number Information
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NPI Number | 1821017047
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Entity Type | Individual
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Provider Name | CHARLES ALBERT ROTTINGHAUS O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 09/22/2011
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Provider Practice Location Address
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Address Line | 200 E 6TH AVE SUITE 112
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City | TOPEKA
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State | KS
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Zip | 66603-3517
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Country | US
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Telephone | 785-235-2374
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Fax |
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Provider Business Mailing Address
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Address Line | 4734 NW VALENCIA RD
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City | SILVER LAKE
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State | KS
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Zip | 66539-9312
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Country | US
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Telephone | 785-582-4553
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Fax |
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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 | 1722
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License Number State | KS
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