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Search › Indiana › 152W00000X

Ricky Weidow, O.D

NPI 1639177793 · on the registry since 2005

Practice

Address
201 W Wayne St
Lagrange, IN 46761
Phone
(260) 463-3421
Fax
(260) 463-7347
Organisation at this address
Renaissance Ocular Disease And Trauma Foundation, Inc.
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
152W00000X
152W00000X
Also registered as
152WC0802X
152WP0200X
Licence states on file
IN
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2010-02-14

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana