Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 1679 | OK |
NPI | 1013947373 |
---|---|
Provider Name | Dr. James Michael Ritze |
First Address | Broken Arrow, OK 74012-7950 |
Second Address | Broken Arrow, OK 74012-7950 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 08/07/2007 |