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General NPI Number Information
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NPI Number | 1942291372
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Entity Type | Individual
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Provider Name | THEODORE F RITZER MD
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Gender | Male
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Dates
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Enumeration Date | 11/03/2005
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Last Update Date | 07/15/2013
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Provider Practice Location Address
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Address Line | 647 DUNLOP LN STE 101
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City | CLARKSVILLE
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State | TN
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Zip | 37040-5165
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Country | US
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Telephone | 931-502-3750
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Fax | 931-502-3755
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Provider Business Mailing Address
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Address Line | 647 DUNLOP LN SUITE 203
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City | CLARKSVILLE
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State | TN
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Zip | 37040-5165
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Country | US
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Telephone | 931-502-3750
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Fax | 931-502-3755
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 21394
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License Number State | TN
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