DR. Ricky Lee Weidow, O.D.

NPI #1639177793 in Lagrange, Indiana

Provider Information

NPI Number: 1639177793
Entity Type: Individual
Name: DR. Ricky Lee Weidow, O.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Jul 12, 2005
Last Updated: Feb 14, 2010

Practice Location

Address: 201 W WAYNE ST
City: Lagrange
State: Indiana
ZIP Code: 46761-1850
Phone: (260) 463-3421

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary
Optometrist - Corneal and Contact Management — Corneal and Contact Management	152WC0802X
Optometrist - Pediatrics — Pediatrics	152WP0200X

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Organizations

Provider Name	Specialty	City
Renaissance Ocular Disease and Trauma Foundation, Inc.	Optometrist	Lagrange	AI Deep Dive

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