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General NPI Number Information
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NPI Number | 1063449007
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Entity Type | Individual
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Provider Name | JOHN W VINSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 10/25/2010
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Provider Practice Location Address
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Address Line | 345 US HIGHWAY 64
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City | ADAMSVILLE
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State | TN
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Zip | 38310-4078
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Country | US
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Telephone | 731-632-3383
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Fax | 731-632-3762
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Provider Business Mailing Address
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Address Line | 345 US HIGHWAY 64
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City | ADAMSVILLE
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State | TN
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Zip | 38310-4078
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Country | US
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Telephone | 731-632-3383
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Fax | 731-632-3762
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 29859
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License Number State | TN
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