Andersen, Rick D
Andersen, Rick D is an sole proprietor health care provider with primary practice located at 1421 Washington Ave , Racine WI 53403-2254. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Vision Therapy. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Andersen, Rick D can be contacted via phone (262) 637-7494.Contact Information
Primary practice address
1421 Washington Ave
Racine WI 53403-2254
Phone: (262) 637-7494
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Optometrist | 152W00000X | 1567 | Wisconsin |
Eye and Vision Services Providers / Pediatrics | 152WP0200X | 1567 | Wisconsin |
Eye and Vision Services Providers / Vision Therapy | 152WV0400X | 1567 | Wisconsin |
Profile Details
NPI number | 1598748790 |
---|---|
LBN Legal business name | Andersen, Rick D |
Credentials | O.D, F.A.A.O. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Nov 22nd, 2005 |
Last updated | Dec 16th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1598748790 | NPPES |
Wisconsin | MEDICAID | 38594700 |
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