Provider Demographics
NPI:1487617718
Name:DINSDALE, RICHARD JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JAMES
Last Name:DINSDALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:840 E MCKELLIPS RD
Mailing Address - Street 2:SUITE101
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203
Mailing Address - Country:US
Mailing Address - Phone:480-834-7546
Mailing Address - Fax:480-833-8313
Practice Address - Street 1:840 E MCKELLIPS RD
Practice Address - Street 2:SUITE101
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-9645
Practice Address - Country:US
Practice Address - Phone:480-834-7546
Practice Address - Fax:480-834-8001
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZMD19143207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ078445Medicaid
AZ25783Medicare PIN
AZ078445Medicaid