Healthcare Provider Details

I. General information

NPI: 1518952993
Provider Name (Legal Business Name): CAREY THOMAS VINSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 03/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 CENTRE AVE
PITTSBURGH PA
15232-1303
US

IV. Provider business mailing address

615 BERKSHIRE DR
PITTSBURGH PA
15215-1514
US

V. Phone/Fax

Practice location:
  • Phone: 412-623-2287
  • Fax:
Mailing address:
  • Phone: 412-781-2516
  • Fax: 412-544-6792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberMD031416E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: