Wortham, Ross C

Wortham, Ross C is an individual health care provider with primary practice located at 400 E Adams Ave , Riverton WY 82501-4413. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wortham, Ross C can be contacted via phone (307) 856-6531.

Contact Information

Primary practice address
400 E Adams Ave Riverton WY 82501-4413
Fax: (307) 856-1306
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X T197 Wyoming

Profile Details

NPI number 1821072042
LBN Legal business name Wortham, Ross C
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2005
Last updated Jan 9th, 2015 - about 11 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 1821072042 NPPES
Wyoming MEDICAID 102280600

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