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Individual

ROBERT CHARLES DICINTIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
203 S ROCK ISLAND AVE, EL RENO, OK 73036-2734
(405) 295-2200
Mailing address
203 S ROCK ISLAND AVE, EL RENO, OK 73036-2734
(405) 295-2200

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
363AM0700X
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200019280A
OK
01
564
STATE LICENSE
OK
Enumeration date
10/11/2006
Last updated
07/08/2007
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