Provider Demographics
NPI:1265496657
Name:RICHTSMEIER, WILLIAM J (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:RICHTSMEIER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-0725
Mailing Address - Country:US
Mailing Address - Phone:607-547-7887
Mailing Address - Fax:607-547-3891
Practice Address - Street 1:1 ATWELL RD
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-1301
Practice Address - Country:US
Practice Address - Phone:607-547-7887
Practice Address - Fax:607-547-3891
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY138228207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01757946Medicaid
NY01757946Medicaid
NYBB8715Medicare ID - Type UnspecifiedUPSTATE