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NPI Code Detail

MEDICARE: JOHN ROBERT VINCENT M.D.

MEDICARE:   JOHN ROBERT VINCENT  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist02495TN

General Provider Information

NPI Number : 1023216470
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN ROBERT VINCENT M.D.
Provider Business Mailing Address
First Line : 7398 W. DESOTO RD
Second Line :
City : WALLS
State : MS
Zip : 38680
Country : US
Telephone Number : 662-781-1289
Fax Number :
Provider Business Practice Location Address
First Line : 8573 CORDES CIR
Second Line :
City : GERMANTOWN
State : TN
Zip : 38139-3317
Country : US
Telephone Number : 901-754-6733
Fax Number : 901-754-7808
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2007
Last Update Date : 07/08/2007

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Directions to “ JOHN ROBERT VINCENT M.D.” Practice Location

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