Individual
DR. JUSTIN JAMES DILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3126 S JACKSON AVE, STE 101, JOPLIN, MO 64804-2534
(417) 208-3465
Mailing address
3126 S JACKSON AVE, STE 101, JOPLIN, MO 64804-2534
(417) 208-3465
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2014010517
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003103490
—
MO
Enumeration date
07/06/2011
Last updated
11/07/2014
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