| Organization Name: | SANDRA KAY DIMMITT M.D. PC |
| NPI Number: | 1710201298 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RENEE BERRYMAN (CFO) |
| Mailing Address: | 2642 E 21st St Ste 285 Tulsa |
| State: | OK US |
| Postal Code: | 741141789 |
| Phone Number: | 9185748800 |
| Fax Number: | 9185748801 |
| NPI Enumeration Date: | 03/26/2010 |
| NPI Last Update Date: | 01/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 11700 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |