MEDICARE: DR. VERNON DWAYNE BREWER D.O.

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	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	03335	KY
2	207Q00000X	Family Medicine Physician	03335	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	:	1558524199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VERNON DWAYNE BREWER D.O.

Provider Business Mailing Address
First Line	:	103 ALYCIA DR
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-2368
Country	:	US
Telephone Number	:	859-624-6515
Fax Number	:	859-624-6514

Provider Business Practice Location Address
First Line	:	103 ALYCIA DR
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-2368
Country	:	US
Telephone Number	:	859-624-6515
Fax Number	:	859-624-6514

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

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	09/24/2025

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