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NPI Code Detail

MEDICARE: DR. WILLIAM VERNON RITZEL O.D.

MEDICARE: DR. WILLIAM VERNON RITZEL 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
1152W00000XOptometrist46-9636IL
2152WC0802XCorneal and Contact Management Optometrist46-9636IL
3152WP0200XPediatric Optometrist46-9636IL
4152WS0006XSports Vision Optometrist46-9636IL
5152WX0102XOccupational Vision Optometrist46-9636IL

General Provider Information

NPI Number : 1699763458
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM VERNON RITZEL O.D.
Provider Business Mailing Address
First Line : 22 N JACKSON ST
Second Line :
City : BELLEVILLE
State : IL
Zip : 62220-1425
Country : US
Telephone Number : 618-233-1270
Fax Number : 618-233-5939
Provider Business Practice Location Address
First Line : 22 N JACKSON ST
Second Line :
City : BELLEVILLE
State : IL
Zip : 62220-1425
Country : US
Telephone Number : 618-233-1270
Fax Number : 618-233-5939
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2005
Last Update Date : 11/10/2010

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