Provider Demographics
NPI:1275312795
Name:TRIPLITT, DUSTIN DANE
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:DANE
Last Name:TRIPLITT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 S PAYNE ST
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-3954
Mailing Address - Country:US
Mailing Address - Phone:405-269-0837
Mailing Address - Fax:
Practice Address - Street 1:403 S PAYNE ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-3954
Practice Address - Country:US
Practice Address - Phone:405-269-0837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist