Healthcare Provider Details

I. General information

NPI: 1033192273
Provider Name (Legal Business Name): ROBERT J ALAIMO JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 11/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 E 12TH ST
THE DALLES OR
97058-3213
US

IV. Provider business mailing address

PO BOX 1520
THE DALLES OR
97058-1004
US

V. Phone/Fax

Practice location:
  • Phone: 541-296-9151
  • Fax: 541-296-9156
Mailing address:
  • Phone: 541-296-7668
  • Fax: 541-296-6431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO16458
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: