Dr. Justin James Dillingham
Family Doctor
3126 S Jackson Ave Ste 101
Joplin
, Missouri 64804-2534
Dr. Justin James Dillingham
Family Doctor
3126 S Jackson Ave Ste 101
Joplin
, Missouri 64804-2534
(417) 208-3465
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About
Features
Specialties
- Family Doctor
Languages spoken
- English
Location
First Address
- Dr. Justin James Dillingham
- 3126 S Jackson Ave Ste 101
- Joplin, MO
- Zip : 64804-2534
- Phone : (417) 208-3465
Second Address
- Dr. Justin James Dillingham
- 3126 S Jackson Ave Ste 101
- Joplin, MO
- Zip : 64804-2534
- Phone : (417) 208-3465
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Q00000X | Family Doctor | 2014010517 | MO |
National Provider Identifier
| NPI | 1003103490 |
|---|---|
| Provider Name | Dr. Justin James Dillingham |
| First Address | Joplin, MO 64804-2534 |
| Second Address | Joplin, MO 64804-2534 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/07/2011 |
| Last Update Date | 07/11/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1003103490 | (05) | MO |
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.