Provider Demographics
NPI:1184607137
Name:BARTOLOVICH, WILLIAM GEORGE (OD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GEORGE
Last Name:BARTOLOVICH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DUTTON DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-1818
Mailing Address - Country:US
Mailing Address - Phone:330-746-7691
Mailing Address - Fax:330-743-8322
Practice Address - Street 1:10 DUTTON DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-1818
Practice Address - Country:US
Practice Address - Phone:330-746-7691
Practice Address - Fax:330-743-8322
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH152WOOOOOX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH110304OtherEYEMED
OH0489636Medicaid
OH580031358OtherRAILROAD MEDICARE
OH2683OtherVBA
OH34110468300OtherWORKERS COMPENSATION
OH360199OtherNVA
OH73876OtherCLARITY
OH2290061OtherUNITED HEALTHCARE
OH73876OtherMOUNTAIN STATE
OH000000127326OtherBLUE CROSS
OH009026OtherCHAMPUS
OH4405115OtherAETNA
OH009026OtherCHAMPUS
OH0489636Medicaid