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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598748790 NPPES
Wisconsin MEDICAID 38594700

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