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General NPI Number Information
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NPI Number | 1316050495
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Entity Type | Individual
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Provider Name | JOHN ALAN VINSON PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 417 S VICTORY ST
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City | LITTLE ROCK
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State | AR
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Zip | 72201-2932
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Country | US
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Telephone | 501-372-5250
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Fax |
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Provider Business Mailing Address
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Address Line | 7403 WORTH AVE E
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City | BENTON
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State | AR
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Zip | 72019-6886
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Country | US
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Telephone | 479-462-9640
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 09847
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PD09847
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License Number State | AR
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