Healthcare Provider Details

I. General information

NPI: 1205149242
Provider Name (Legal Business Name): VINCI SAMUEL JONES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 23RD AVE N STE 350
NASHVILLE TN
37203-1650
US

IV. Provider business mailing address

330 23RD AVE N STE 350
NASHVILLE TN
37203-1650
US

V. Phone/Fax

Practice location:
  • Phone: 615-277-2300
  • Fax: 615-320-1849
Mailing address:
  • Phone: 615-277-2300
  • Fax: 615-320-1849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number76131
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: