Wittkop, Dale L

Wittkop, Dale L is an individual health care provider with primary practice located at 123 Locust St , Allegan MI 49010-1301. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wittkop, Dale L can be contacted via phone (269) 673-5100.

Contact Information

Primary practice address
123 Locust St Allegan MI 49010-1301
Fax: (269) 673-1806
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 49010003042 Michigan

Profile Details

NPI number 1447256136
LBN Legal business name Wittkop, Dale L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Feb 14th, 2012 - about 14 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 1447256136 NPPES
Other 900Z310140 BCBS OF MICHIGAN
Other 900Z365250 BCBS OF MICHIGAN
MEDICAID 944193774 BCBS OF MICHIGAN

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