MEDICARE: JEAN M. DORNFELD-FINKE 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	38566	KY

General Provider Information

NPI Number	:	1235131756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN M. DORNFELD-FINKE M.D.

Provider Business Mailing Address
First Line	:	112 W HIGH ST
Second Line	:
City	:	MT STERLING
State	:	KY
Zip	:	40353-1357
Country	:	US
Telephone Number	:	859-498-5784
Fax Number	:	859-498-4701

Provider Business Practice Location Address
First Line	:	112 W HIGH ST
Second Line	:
City	:	MT STERLING
State	:	KY
Zip	:	40353-1357
Country	:	US
Telephone Number	:	859-498-5784
Fax Number	:	859-498-4701

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	07/08/2007

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