Provider Demographics
NPI:1750515979
Name:DISSELKAMP, MARGARET ANN (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:DISSELKAMP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:UK DIVISION OF PULMONARY CRITICAL CARE
Mailing Address - Street 2:740 S. LIMESTONE, L543 KY CLINIC
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0284
Mailing Address - Country:US
Mailing Address - Phone:859-323-5045
Mailing Address - Fax:859-257-2418
Practice Address - Street 1:UK DIVISION OF PULMONARY CRITICAL CARE
Practice Address - Street 2:740 S. LIMESTONE, L543 KY CLINIC
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0284
Practice Address - Country:US
Practice Address - Phone:859-323-9555
Practice Address - Fax:859-257-9286
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2016-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY46032207R00000X, 208000000X, 207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine