MEDICARE: DR. JOHN JAMES DITMARS JR. DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	142	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	480019883	OTHER	OK	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	73-1490445-003	OTHER	OK	BLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number	:	1033140983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN JAMES DITMARS JR. DPM

Provider Business Mailing Address
First Line	:	PO BOX 610
Second Line	:
City	:	EL RENO
State	:	OK
Zip	:	73036-0610
Country	:	US
Telephone Number	:	405-262-6613
Fax Number	:	405-262-1088

Provider Business Practice Location Address
First Line	:	1620 W ELM ST
Second Line	:
City	:	EL RENO
State	:	OK
Zip	:	73036-4202
Country	:	US
Telephone Number	:	405-262-6613
Fax Number	:	405-262-1088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	06/06/2013

Similar Medicare Providers

1023286382 — JOHN JAMES DITMARS, JR. DPM, PC
Practice Location Address:

1620 W ELM ST
EL RENO, OK
73036-4202

Practice Phone: 405-262-6613
Practice Fax: 405-262-1088

1942464151 — RODRIGO J. ALFARO M.D.
Practice Location Address:

1566 LOMALAND DRIVE
EL PASO, TX
79935-4202

Practice Phone: 915-544-7767
Practice Fax: 915-532-6938

1477547552 — ADVANT EDGE PHARMACY, INC
Practice Location Address:

1576 LOMALAND DR
EL PASO, TX
79935-4202

Practice Phone: 915-595-0409
Practice Fax: 915-595-1306

1174584114 — KIDNEY CONSULTANTS OF EL PASO
Practice Location Address:

1566 LOMALAND DR
EL PASO, TX
79935-4202

Practice Phone: 915-544-7767
Practice Fax: 915-532-6938

1194831255 — MS. KIMCHI T DO DDS
Practice Location Address:

4202 N PECK RD
EL MONTE, CA
91732

Practice Phone: 626-401-0012
Practice Fax: 626-401-1009

1003994518 — ADVANT-EDGE PHARMACY, INC
Practice Location Address:

1576 LOMALAND DR
EL PASO, TX
79935-4202

Practice Phone: 915-595-0409
Practice Fax: 915-595-1028

Directions to “ DR. JOHN JAMES DITMARS JR. DPM” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.