Rettele, Garrick A

Rettele, Garrick A is an individual health care provider with primary practice located at 1411 W 4Th St Ste D, Coffeyville KS 67337-3300. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Rettele, Garrick A can be contacted via phone (620) 251-3235.

Contact Information

Primary practice address
1411 W 4Th St Ste D Coffeyville KS 67337-3300
Phone: (620) 251-3235
Fax: (620) 251-3252
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 04-26308 Kansas

Profile Details

NPI number 1801892898
LBN Legal business name Rettele, Garrick A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Feb 11th, 2008 - about 17 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 1801892898 NPPES
Kansas Other 041849 BCBS OF KS
Kansas MEDICAID 100190920A BCBS OF KS

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