Provider Demographics
NPI:1568499788
Name:DINGER, PAMELA S (RPT)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:S
Last Name:DINGER
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1379
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-1379
Mailing Address - Country:US
Mailing Address - Phone:479-524-8028
Mailing Address - Fax:479-524-6151
Practice Address - Street 1:1675 W. JEFFERSON
Practice Address - Street 2:SUITE A
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-1379
Practice Address - Country:US
Practice Address - Phone:479-524-8028
Practice Address - Fax:479-524-6151
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3874225100000X
ARPT 2530225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5W618Medicare ID - Type Unspecified