Healthcare Provider Details

I. General information

NPI: 1528487543
Provider Name (Legal Business Name): BARBARA VINCI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2443 TROY RD
SPRINGFIELD OH
45504-4233
US

IV. Provider business mailing address

2111 E STATE ST
ATHENS OH
45701-2138
US

V. Phone/Fax

Practice location:
  • Phone: 937-505-6505
  • Fax:
Mailing address:
  • Phone: 740-300-1746
  • Fax: 740-331-7676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57.024668
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number35.133880
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: