Provider Demographics
NPI:1023080785
Name:DILLMAN, JUDITH BURTON (MD)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:BURTON
Last Name:DILLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:540 E JEFFERSON ST
Mailing Address - Street 2:STE 106
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-2479
Mailing Address - Country:US
Mailing Address - Phone:319-354-2653
Mailing Address - Fax:319-339-1364
Practice Address - Street 1:500 E MARKET ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2689
Practice Address - Country:US
Practice Address - Phone:319-354-2653
Practice Address - Fax:319-339-1364
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23074207L00000X
UT1737921205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1195800Medicaid
IA1195800Medicaid
IA59141Medicare ID - Type Unspecified