Provider Demographics
NPI:1366727661
Name:ROBERT C. DIMSKI, PLLC
Entity type:Organization
Organization Name:ROBERT C. DIMSKI, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:DIMSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-455-3636
Mailing Address - Street 1:9070 HARMONY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-6256
Mailing Address - Country:US
Mailing Address - Phone:405-455-3636
Mailing Address - Fax:405-455-3601
Practice Address - Street 1:9070 HARMONY DR
Practice Address - Street 2:SUITE B
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-6256
Practice Address - Country:US
Practice Address - Phone:405-455-3636
Practice Address - Fax:405-455-3601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-18
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty