Joseph Lee Dibble, R.D.
Individual provider Active NPI Clinic/Center · Yerington, NV
NPI 1780713610 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1780713610
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinic/Center 261Q00000X
- Practice address
- 171 Campbell LN
Yerington, NV 89447-9731 - Phone
- (775) 463-3335
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88-6005135 | NV | MD | Clinic/Center |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | NV | Yes |
Addresses
Primary practice location
171 Campbell LN
Yerington, NV 89447-9731
Mailing address
5499 Breeze CT
Sun Valley, NV 89433-6505
Phone (775) 673-8630
Other providers in Yerington, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.