MEDICARE: WILLIAM GEORGE BARTOLOVICH O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	152WOOOOOX	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	580031358	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110304	OTHER	OH	EYEMED
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	2683	OTHER	OH	VBA
5	34110468300	OTHER	OH	WORKERS COMPENSATION
6	360199	OTHER	OH	NVA
7	73876	OTHER	OH	CLARITY
8	2290061	OTHER	OH	UNITED HEALTHCARE
9	73876	OTHER	OH	MOUNTAIN STATE
10	000000127326	OTHER	OH	BLUE CROSS
11	009026	OTHER	OH	CHAMPUS
12	4405115	OTHER	OH	AETNA

General Provider Information

NPI Number	:	1184607137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM GEORGE BARTOLOVICH O.D.

Provider Business Mailing Address
First Line	:	10 DUTTON DR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44502-1818
Country	:	US
Telephone Number	:	330-746-7691
Fax Number	:	330-743-8322

Provider Business Practice Location Address
First Line	:	10 DUTTON DR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44502-1818
Country	:	US
Telephone Number	:	330-746-7691
Fax Number	:	330-743-8322

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	02/09/2016

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