Basic Information
| Provider Information | |||||||||
| NPI: | 1346350865 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DINSMORE | ||||||||
| FirstName: | PHILIP | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3366 | ||||||||
| Address2: | |||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477323366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124502240 | ||||||||
| FaxNumber: | 8124502710 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 MARY ST | ||||||||
| Address2: | |||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477101674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124502240 | ||||||||
| FaxNumber: | 8124502710 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 11/20/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 13538 | OR | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 43104 | WA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 01061942A | IN | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 036-062266 | IL | N | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 036062266 | 05 | IL | MEDICAID | 200842510 | 05 | IN | MEDICAID |