Provider Demographics
NPI:1710083589
Name:DINGLE, DONALD LLOYD (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:LLOYD
Last Name:DINGLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:OK
Mailing Address - Zip Code:74525-3710
Mailing Address - Country:US
Mailing Address - Phone:580-889-3338
Mailing Address - Fax:580-889-5145
Practice Address - Street 1:621 W 13TH ST
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-3710
Practice Address - Country:US
Practice Address - Phone:580-889-3338
Practice Address - Fax:580-889-5145
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1720111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKQDCKHMedicare ID - Type Unspecified
OKT75230Medicare UPIN