Dittmeyer, Brent Eugene

Dittmeyer, Brent Eugene is an individual health care provider with primary practice located at 4010 W Owen K Garriott Rd , Enid OK 73703-4803. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Dittmeyer, Brent Eugene can be contacted via phone (580) 234-8021.

Contact Information

Primary practice address
4010 W Owen K Garriott Rd Enid OK 73703-4803
Phone: (580) 234-8021
Fax: (580) 233-9363
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 9617 Oklahoma

Profile Details

NPI number 1679895502
LBN Legal business name Dittmeyer, Brent Eugene
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 19th, 2010
Last updated Feb 19th, 2010 - about 15 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 1679895502 NPPES
Oklahoma MEDICAID 100235410F

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