| Organization Name: | JOHN JAMES DITMARS, JR. DPM, PC |
| NPI Number: | 1023286382 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN JAMES DITMARS (PRESIDENT) |
| Mailing Address: | 1620 W Elm St El Reno |
| State: | OK US |
| Postal Code: | 730364202 |
| Phone Number: | 4052626613 |
| Fax Number: | 4052621088 |
| NPI Enumeration Date: | 02/20/2008 |
| NPI Last Update Date: | 03/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | 142 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |