Basic Information
| Provider Information | |||||||||
| NPI: | 1730374653 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUMONT | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7545 BEECHMONT AVE | ||||||||
| Address2: | SUITE C | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452554222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135644026 | ||||||||
| FaxNumber: | 5135644027 | ||||||||
| Practice Location | |||||||||
| Address1: | 7545 BEECHMONT AVE | ||||||||
| Address2: | SUITE C | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452554222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135644026 | ||||||||
| FaxNumber: | 5135644027 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2007 | ||||||||
| LastUpdateDate: | 10/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35091465 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0061556 | 05 | OH | MEDICAID | 7100228920 | 05 | KY | MEDICAID |