Individual
THOMAS GERALD DISESSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3945 PEPPERTREE DR, LEXINGTON, KY 40513-1398
(859) 219-8632
Mailing address
3945 PEPPERTREE DR, LEXINGTON, KY 40513-1398
(859) 219-8632
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
38090
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64920507
—
KY
Enumeration date
07/19/2006
Last updated
09/02/2015
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