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NPI Code Detail

MEDICARE: SETH VINCENT

MEDICARE:   SETH  VINCENT
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
1363A00000XPhysician Assistant5601011886MI

General Provider Information

NPI Number : 1699407189
Entity Type Code : Individual
Provider Name (Legal Business Name) : SETH VINCENT
Provider Business Mailing Address
First Line : 8475 SKIFF LAKE RD
Second Line :
City : JACKSON
State : MI
Zip : 49201-8369
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8475 SKIFF LAKE RD
Second Line :
City : JACKSON
State : MI
Zip : 49201-8369
Country : US
Telephone Number : 517-499-8803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2022
Last Update Date : 07/06/2023

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Directions to “ SETH VINCENT ” Practice Location

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