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Contact Information

JOHN J DITMARS JR, DPM
1620 W ELM ST
EL RENO, OK73036-4202
 Phone: 405-262-6613
 Fax: 405-262-1088
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JOHN J DITMARS JR · (Male)

NPI Number 1033140983
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 07/06/2006
Last updated 06/06/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • OK License # 142
  • OK Medicaid 100780220A
  • OK Other 73-1490445-003 BLUE CROSS & BLUE SHIELD
  • OK Other 480019883 RR MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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