Organization
REDWELL & WIETIES EYECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM H BEDWELL O.D. (PARTNER / OPTOMETRIST)
(618) 544-3525
Entity
Organization
Contact information
Practice address
905 W MEFFORD ST, ROBINSON, IL 62454-1065
(618) 544-3525
(618) 544-3261
Mailing address
P.O. BOX 658, 905 W. MEFFORD ST., ROBINSON, IL 62454-1065
(618) 544-3525
(618) 544-3261
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-007815
IL
152W00000X
Optometrist
046-008222
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BEDWELL 046-007815
—
IL
01
—
BEDWELL 0790230001
PALMETTO GBA
—
05
—
WIETIES 046-008222
—
IL
01
—
WIETIES P01082010
PALMETTO GBA
—
Enumeration date
11/27/2012
Last updated
11/27/2012
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