Provider Demographics
NPI:1578564878
Name:MEESE TOLLAND RITTER & WILLIAMS MD PA
Entity Type:Organization
Organization Name:MEESE TOLLAND RITTER & WILLIAMS MD PA
Other - Org Name:COLON & RECTAL SURGERY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:MEESE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-672-0017
Mailing Address - Street 1:550 MEMORIAL CIR
Mailing Address - Street 2:SUITE H
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-5059
Mailing Address - Country:US
Mailing Address - Phone:386-672-0017
Mailing Address - Fax:386-676-0506
Practice Address - Street 1:550 MEMORIAL CIR
Practice Address - Street 2:SUITE H
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5059
Practice Address - Country:US
Practice Address - Phone:386-672-0017
Practice Address - Fax:386-676-0506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043283100Medicaid
FL00819Medicare PIN
FLD57734Medicare UPIN