Individual provider · Type 1 NPI
Robert Franklin Dettmer Sr., MD
General Practice Physician · Ironton, MO
NPI number
1194074302
Active
Practice location
3 Longwood Lane
Ironton, MO 63650-0307
Fax (573) 546-2741
Mailing address
PO Box 307, #3 Longwood Lane
Ironton, MO 63650-0307
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | 28191M.D. (MO) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
About NPI 1194074302
Robert Franklin Dettmer Sr., MD's National Provider Identifier is 1194074302, issued on Sep 4, 2012. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Ironton, MO. The record was last updated on Sep 4, 2012.