MEDICARE: DR. VINCENT BERNARD DUMMER PSY.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	103T00000X	Psychologist	0534	KY

General Provider Information

NPI Number	:	1801876990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT BERNARD DUMMER PSY.D.

Provider Business Mailing Address
First Line	:	436 W SECOND ST
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40507-1040
Country	:	US
Telephone Number	:	859-231-7137
Fax Number	:

Provider Business Practice Location Address
First Line	:	436 W SECOND ST
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40507-1040
Country	:	US
Telephone Number	:	859-231-7137
Fax Number	:

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

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	09/16/2013

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