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General NPI Number Information
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NPI Number | 1114012614
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Entity Type | Individual
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Provider Name | VINCENT ANTHONY ESCANDELL PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 11/03/2021
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Provider Practice Location Address
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Address Line | 1585 3RD ST
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City | FORT POLK
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State | LA
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Zip | 71459-5102
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Country | US
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Telephone | 318-473-0010
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Fax | 318-483-5096
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Provider Business Mailing Address
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Address Line | BAYNE-JONES ARMY COMMUNITY HOSPITAL 1585 THIRD ST
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City | FORT POLK
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State | LA
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Zip | 71459
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Country | US
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Telephone | 318-451-1115
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Fax | 318-448-9088
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 784
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 784
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License Number State | LA
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