MEDICARE: DR. KARLA JEAN DICKMEYER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	39842-020	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336104421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARLA JEAN DICKMEYER M.D.

Provider Business Mailing Address
First Line	:	5801 RESEARCH PARK BLVD
Second Line	:	SUITE 400
City	:	MADISON
State	:	WI
Zip	:	53719-6002
Country	:	US
Telephone Number	:	608-729-6300
Fax Number	:	608-729-1099

Provider Business Practice Location Address
First Line	:	5801 RESEARCH PARK BLVD
Second Line	:	SUITE 400
City	:	MADISON
State	:	WI
Zip	:	53719-6002
Country	:	US
Telephone Number	:	608-729-6300
Fax Number	:	608-729-1099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	05/31/2022

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