Dr. Dean L Mittman
Dermatologist
2115 S Fremont Ave Suite 2100
Springfield
, Missouri 65804-2239
Dr. Dean L Mittman
Dermatologist
2115 S Fremont Ave Suite 2100
Springfield
, Missouri 65804-2239
(417) 829-4620
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Dr. Dean L Mittman
- Po Box 2580
- Springfield, MO
- Zip : 65801-2580
- Phone : (417) 829-4620
Second Address
- Dr. Dean L Mittman
- 2115 S Fremont Ave Suite 2100
- Springfield, MO
- Zip : 65804-2239
- Fax : (417) 820-7223
- Phone : (417) 820-7720
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | 111705 | MO |
National Provider Identifier
| NPI | 1043359292 |
|---|---|
| Provider Name | Dr. Dean L Mittman |
| First Address | Springfield, MO 65801-2580 |
| Second Address | Springfield, MO 65804-2239 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/02/2007 |
| Last Update Date | 09/05/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 110426 | MO MEDICARE (01) | MO |
| 142569001 | (05) | AR |
| 208573014 | (05) | MO |
| 81287 | ARK BLUE SHIELD (01) | AR |
| E55673 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.