Disessa, Thomas Gerald

Disessa, Thomas Gerald is an individual health care provider with primary practice located at 3945 Peppertree Dr , Lexington KY 40513-1398. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as his primary health care specialty. Disessa, Thomas Gerald can be contacted via phone (859) 219-8632.

Contact Information

Primary practice address
3945 Peppertree Dr Lexington KY 40513-1398
Phone: (859) 219-8632
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 38090 Kentucky

Profile Details

NPI number 1780604462
LBN Legal business name Disessa, Thomas Gerald
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Sep 2nd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780604462 NPPES
Kentucky MEDICAID 64920507

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