Provider Demographics
NPI:1457605867
Name:DIM PHYSICIANS LLC
Entity Type:Organization
Organization Name:DIM PHYSICIANS LLC
Other - Org Name:DUBLIN INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO - SRPCC
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:MARCUS
Authorized Official - Last Name:O'STEEN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:912-538-5314
Mailing Address - Street 1:PO BOX 407
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30475-0407
Mailing Address - Country:US
Mailing Address - Phone:912-537-4986
Mailing Address - Fax:912-538-8166
Practice Address - Street 1:104 FAIRVIEW PARK DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2500
Practice Address - Country:US
Practice Address - Phone:478-272-1366
Practice Address - Fax:478-272-2240
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHEAST REGIONAL. PRIMARY CARE CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-07
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty