Dr Ricky Lee Weidow, OD is a medicare enrolled "Optometrist" provider in Lagrange, Indiana. His current practice location is
201 W Wayne St, Lagrange, Indiana. You can reach out to his office (for appointments etc.) via phone at
(260) 463-3421.
Dr Ricky Lee Weidow is licensed to practice in Indiana (license number 18002670A/B) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1639177793.
Healthcare Provider's Profile
| Full Name | Dr Ricky Lee Weidow |
|---|
| Gender | Male |
|---|
| Speciality | |
|---|
| Experience | Years |
|---|
| Location | 201 W Wayne St, Lagrange, Indiana |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Ricky Lee Weidow attended and graduated from in
NPI Data:
- NPI Number: 1639177793
- Provider Enumeration Date: 07/12/2005
- Last Update Date: 02/14/2010
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Dr Ricky Lee Weidow such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1639177793 | NPI | - | NPPES |
| 000000635212 | Other | IN | ANTHEM BC/BS NWIELC KNOX |
| 2604633421 | Other | IN | VISION SERVICE PLAN LAGRANGE |
| 5742334109 | Other | IN | VISION SERVICE PLAN SOUTH BEND |
| 2605932505 | Other | IN | VISION SERVICE PLAN TOPEKA |
| 000000257711 | Other | IN | ANTHEM BC/BS LAGRANGE |
| 000000257712 | Other | IN | ANTHEM BC/BS TOPEKA |
| 1174740682 | Other | IN | RENAISSANCE OCULAR DISEASE AND TRAUMA FOUNDATION TYPE 2 GROUP NPI |
| 200097680C | Medicaid | IN | |
| 200097680E | Medicaid | IN | |
| 200097680D | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 18002670A/B (Indiana) | Primary |
| 152WC0802X | Optometrist - Corneal And Contact Management | 18002670A/B (Indiana) | Secondary |
| 152WP0200X | Optometrist - Pediatrics | 18002670A/B (Indiana) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Ricky Lee Weidow is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Ricky Lee Weidow, OD
201 W Wayne St, Po Box 150,
Lagrange, IN 46761-1850
Ph: (260) 463-3421 | Dr Ricky Lee Weidow, OD
201 W Wayne St,
Lagrange, IN 46761-1850
Ph: (260) 463-3421 |
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