Provider Demographics
NPI:1376699348
Name:DINN, ROBERT B (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:DINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:B
Other - Last Name:DINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3433 S LAFOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-3801
Mailing Address - Country:US
Mailing Address - Phone:765-453-3777
Mailing Address - Fax:765-453-6577
Practice Address - Street 1:3433 S LAFOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3801
Practice Address - Country:US
Practice Address - Phone:765-453-3777
Practice Address - Fax:765-453-6577
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01063134A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN364590HMedicare PIN
IN362350OMedicare PIN
IN199260EMedicare PIN
IN0258130002Medicare NSC
IN0258130003Medicare NSC
INI72821Medicare UPIN
IN0258130001Medicare NSC