Renaissance Ocular Disease And Trauma Foundation, Inc. is a Eyewear Supplier (equipment, Not The Service) Center in Lagrange, Indiana. It is situated at 201 W Wayne St, Lagrange and its contact number is 260-463-3421. The authorized person of Renaissance Ocular Disease And Trauma Foundation, Inc. is Dr. Ricky Lee Weidow
who is President of the clinic and their contact number is 260-463-3421. Primary license number for Renaissance Ocular Disease And Trauma Foundation, Inc. is 18002670A/B (Optometrist) in Indiana.
Renaissance Ocular Disease And Trauma Foundation, Inc. Center An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Complete Center Profile:
Renaissance Ocular Disease And Trauma Foundation, Inc. Center speciality, address, contact phone number and fax are as below.
Patients can call the eye care center on the below given phone number for appointment.
| Specialization: | Eyewear Supplier (equipment, Not The Service) |
| Clinic Address: | 201 W Wayne St, Lagrange,
Indiana, 46761-1850 |
| Phone: | 260-463-3421 |
| Fax: | 260-463-7347 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Ricky Lee Weidow |
| Position: | President |
| Contact Number: | 260-463-3421 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Renaissance Ocular Disease And Trauma Foundation, Inc. Center are as mentioned below.
| NPI Number: | 1174740682 |
| NPI Enumeration Date: | 19 Apr, 2007 |
| NPI Last Update On: | 27 Feb, 2010 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Renaissance Ocular Disease And Trauma Foundation, Inc. are as mentioned below.
| Specialization | License Number | State | Status | |
| Optometrist | 18002670A/B | Indiana | Primary | |
| Eyewear Supplier (equipment, Not The Service) | 18002670A/B | Indiana | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2605932505 | Other | Indiana | Vision Service Plan Topeka |
| 5742334109 | Other | Indiana | Vision Service Plan South Bend |
| 200097680D | Medicaid | Indiana | |
| 2604633421 | Other | Indiana | Vision Service Plan Lagrange |
| 000000257711 | Other | Indiana | Anthem Bc/bs Lagrange |
| 000000257712 | Other | Indiana | Anthem Bc/bs Topeka |
| 000000635212 | Other | Indiana | Anthem Nwielc Knox |
| 200097680E | Medicaid | Indiana | |
| 1639177793 | Other | Indiana | Ricky Weidow Npi |
| 200097680C | Medicaid | Indiana | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Renaissance Ocular Disease And Trauma Foundation, Inc.
201 W Wayne St, Po Box 150
Lagrange, Indiana |
| Zip: | 46761-1850 |
| Phone Number: | 260-463-3421 |
| Fax Number: | 260-463-7347 |
Patients can reach Renaissance Ocular Disease And Trauma Foundation, Inc. at
201 W Wayne St, Lagrange, Indiana or can
call to book an appointment on 260-463-3421.
Comments/ Reviews:
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** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.