MEDICARE: DR. D. GENE DILLMAN II MD

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	207Q00000X	Family Medicine Physician	29763	KY

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	:	1477532703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. D. GENE DILLMAN II MD

Provider Business Mailing Address
First Line	:	1517 NICHOLASVILLE RD
Second Line	:	UNIT 404
City	:	LEXINGTON
State	:	KY
Zip	:	40503-1429
Country	:	US
Telephone Number	:	859-255-7918
Fax Number	:	859-254-0515

Provider Business Practice Location Address
First Line	:	1517 NICHOLASVILLE RD
Second Line	:	UNIT 404
City	:	LEXINGTON
State	:	KY
Zip	:	40503-1429
Country	:	US
Telephone Number	:	859-255-7918
Fax Number	:	859-254-0515

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

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	04/06/2011

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