Brandon Scott Dugan, PSY,D,, LP
Individual provider Active NPI Psychologist · Fairmont, MN
NPI 1144535964 · NPPES record last updated May 3, 2017
Key facts
- NPI
- 1144535964
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- LP5279 (MN)
- Practice address
- 1420 N State St
Fairmont, MN 56031-3619 - Phone
- (507) 235-6070
- Fax
- (507) 235-6074
- NPI assigned
- Aug 17, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP5279 | MN | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP5279 | MN | Yes |
Addresses
Primary practice location
1420 N State St
Fairmont, MN 56031-3619
Mailing address
1420 N State St
Fairmont, MN 56031-3619
Phone (507) 235-6070
Other providers in Fairmont, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.