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Individual
DR. SANDRA KAY DIMMITT
Active
Individual
DR. SANDRA KAY DIMMITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11700
OK
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
11700
OK
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
11700
OK
208D00000X
General Practice Physician
Primary
11700
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100200770A
—
OK
01
—
OKA103248
MEDICARE PTAN
OK
Enumeration date
07/10/2006
Last updated
05/01/2014
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