# RICHARD E. DIETZEN, M.D.,P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174738397
- **Authorized official:** DR. RICHARD EDWARD DIETZEN M.D. (PHYSICIAN)
- **Authorized official phone:** (870) 863-6444

## Contact information

- **Practice address:** 403 W OAK ST, SUITE 302, EL DORADO, AR 71730-4586
- **Practice address phone:** (870) 863-6444
- **Practice address fax:** (870) 863-6675
- **Mailing address:** 403 W. OAK ST, SUITE 302, EL DORADO, AR 71730-4586
- **Mailing address phone:** (870) 863-6444
- **Mailing address fax:** (870) 863-6675

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | E-1069 | AR | Yes |

## Other

- **Enumeration date:** 05/11/2007
- **Last updated:** 01/18/2008