Provider Demographics
NPI:1023088259
Name:BAYER, VINCENT LEE (DC)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:LEE
Last Name:BAYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-2503
Mailing Address - Country:US
Mailing Address - Phone:814-480-8180
Mailing Address - Fax:814-480-8182
Practice Address - Street 1:1359 W 6TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-2503
Practice Address - Country:US
Practice Address - Phone:814-480-8180
Practice Address - Fax:814-480-8182
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009258111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001643110OtherBCBS
PA1012958350002Medicaid
PA7313612OtherAETNA PPO
PA3646619OtherAETNA HMO
PA3646619OtherAETNA HMO
PA001643110OtherBCBS