Individual
JASON RUSSELL DILTS
Active
Individual
JASON RUSSELL DILTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01062390A
IN
207P00000X
Emergency Medicine Physician
Primary
2008012452
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200573720A
—
KS
05
—
200573720B
—
KS
05
—
200573720C
—
KS
05
—
200573720D
—
KS
01
—
40474018
BCBS
—
Enumeration date
02/22/2007
Last updated
03/19/2009
Update your record
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