MEDICARE: CAROLE ANN VINCENT DO

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
1	208600000X	Surgery Physician	OS011914	PA
2	208600000X	Surgery Physician	25MB06398300	NJ
3	208600000X	Surgery Physician	DO00838	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497731038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLE ANN VINCENT DO

Provider Business Mailing Address
First Line	:	100 N ACADEMY AVE
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	17822-9800
Country	:	US
Telephone Number	:	570-271-6144
Fax Number	:

Provider Business Practice Location Address
First Line	:	1165 CENTRE TPKE
Second Line	:
City	:	ORWIGSBURG
State	:	PA
Zip	:	17961-9343
Country	:	US
Telephone Number	:	570-968-1300
Fax Number	:	570-968-1305

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	02/27/2024

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Directions to “ CAROLE ANN VINCENT DO” Practice Location

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