Individual
THEODORE F RITZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
647 DUNLOP LN, STE 101, CLARKSVILLE, TN 37040-5165
(931) 502-3750
(931) 502-3755
Mailing address
647 DUNLOP LN, SUITE 203, CLARKSVILLE, TN 37040-5165
(931) 502-3750
(931) 502-3755
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
21394
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3060334
MEDICARE ID - TYPE UNSPECIFIED
TN
05
—
3060335
—
TN
01
—
4185003
BLUE CROSS BLUE SHIELD OF TN
TN
Enumeration date
11/03/2005
Last updated
07/15/2013
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