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Individual

DR. ROBERT F DIBBLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
1120 MAIN ST, WILLIMANTIC, CT 06226-2014
(860) 423-2111
(860) 423-7559
Mailing address
1120 MAIN ST, WILLIMANTIC, CT 06226-2014
(860) 423-2111
(860) 423-7559

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
030376
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001303768
CT
05
004215415
CT
01
010030376CT01
ANTHEM PROVIDER #
CT
01
0122742
AETNA PROVIDER #
CT
01
050058
HEALTHNET PROVIDER ID
CT
01
08-04978
UNITED HEALTHCARE ID#
CT
01
799860
CONNECTICARE PROV #
CT
01
WIS003
OXFORD PROVIDER #
CT
Enumeration date
07/03/2006
Last updated
10/17/2008
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