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
Phone: (269) 673-5100
Fax: (269) 673-1806
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447256136 | NPPES |
| Other | 900Z310140 | BCBS OF MICHIGAN | |
| Other | 900Z365250 | BCBS OF MICHIGAN | |
| MEDICAID | 944193774 | BCBS OF MICHIGAN |
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