Mary Alice Disselkamp, PA-C

NPI #1043876170 in Elizabethtown, Kentucky

Provider Information

NPI Number: 1043876170
Entity Type: Individual
Name: Mary Alice Disselkamp, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: May 14, 2019
Last Updated: Nov 8, 2023

Practice Location

Address: 2407 RING RD STE 108
City: Elizabethtown
State: Kentucky
ZIP Code: 42701-5938
Phone: (270) 706-5787

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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