Provider Demographics
NPI:1467459297
Name:RITCHEY, WILLIAM (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:RITCHEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 KENMORE BLVD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44314-1964
Mailing Address - Country:US
Mailing Address - Phone:330-745-8802
Mailing Address - Fax:330-745-0856
Practice Address - Street 1:1250 KENMORE BLVD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44314-1964
Practice Address - Country:US
Practice Address - Phone:330-745-8802
Practice Address - Fax:330-745-0856
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1643207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0112292Medicaid
OH0112292Medicaid
OHB99619Medicare UPIN