Dewitt, Dexter D

Dewitt, Dexter D is an individual health care provider with primary practice located at 126 E Main St Suite B, Payson AZ 85541-5488. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Dewitt, Dexter D can be contacted via phone (928) 468-5437.

Contact Information

Primary practice address
126 E Main St Suite B Payson AZ 85541-5488
Phone: (928) 468-5437
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 6525 Arizona

Profile Details

NPI number 1093714834
LBN Legal business name Dewitt, Dexter D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Dec 6th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093714834 NPPES
Arizona Other AZ0851710 BCBS
Arizona MEDICAID 0017101703 BCBS

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