Provider Demographics
NPI:1962131771
Name:RATLIFF, WILLIAM (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:RATLIFF
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 W WILSON ST APT 405
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-4284
Mailing Address - Country:US
Mailing Address - Phone:501-581-8656
Mailing Address - Fax:
Practice Address - Street 1:503 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-4941
Practice Address - Country:US
Practice Address - Phone:608-833-0062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3800-35152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist