Organization
JOHN JAMES DITMARS, JR. DPM, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN JAMES DITMARS JR. DPM (PRESIDENT)
(405) 262-6613
Entity
Organization
Contact information
Practice address
1620 W ELM ST, EL RENO, OK 73036-4202
(405) 262-6613
(405) 262-1088
Mailing address
PO BOX 717, EL RENO, OK 73036-0717
(405) 262-6613
(405) 262-1088
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
142
OK
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
142
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200275890 B
—
OK
Enumeration date
02/20/2008
Last updated
03/04/2010
Update your record
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