Healthcare Provider Details

I. General information

NPI: 1487620514
Provider Name (Legal Business Name): RICHARD VINCE OZMENT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 01/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEDICAL PARK DR
CONCORD NC
28025-2982
US

IV. Provider business mailing address

200 MEDICAL PARK DR STE 400
CONCORD NC
28025-0906
US

V. Phone/Fax

Practice location:
  • Phone: 704-786-1108
  • Fax:
Mailing address:
  • Phone: 704-786-1108
  • Fax: 704-782-1826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number36578
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: