Organization
DSO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW DIESSELHORST MD (OWNER)
(405) 463-3337
Entity
Organization
Contact information
Practice address
10914 HEFNER POINTE DR STE 200, OKLAHOMA CITY, OK 73120-5069
(405) 463-3337
(405) 463-3338
Mailing address
10914 HEFNER POINTE DR STE 200, OKLAHOMA CITY, OK 73120-5069
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
05/31/2024
Last updated
05/31/2024
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