Dieckhaus, Kevin O
Dieckhaus, Kevin O is an individual health care provider with primary practice located at 263 Farmington Ave , Farmington CT 06030-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Dieckhaus, Kevin O can be contacted via phone (860) 679-4225.Contact Information
Primary practice address
263 Farmington Ave
Farmington CT 06030-0001
Phone: (860) 679-4225
Fax: (860) 679-1217
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 035297 | Connecticut |
Profile Details
| NPI number | 1316942378 |
|---|---|
| LBN Legal business name | Dieckhaus, Kevin O |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2005 |
| Last updated | Sep 20th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316942378 | NPPES |
| Connecticut | MEDICAID | 001352971 |
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