Provider Demographics
NPI:1881999571
Name:KATTOUF, RICHARD S (OD, DOS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:KATTOUF
Suffix:
Gender:M
Credentials:OD, DOS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22321 KENWOOD ISLE DR
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-7244
Mailing Address - Country:US
Mailing Address - Phone:330-219-5094
Mailing Address - Fax:
Practice Address - Street 1:8133 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2256
Practice Address - Country:US
Practice Address - Phone:330-219-5094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3031152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH931TOtherTHERAPEUTIC