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NPI Code Detail

MEDICARE: VINCE CHARLES TUSA M.D.

MEDICARE: VINCE CHARLES TUSA 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
1207R00000XInternal Medicine PhysicianMD0000010339TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00044222OTHERTNRAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1750363818
Entity Type Code : Individual
Provider Name (Legal Business Name) : VINCE CHARLES TUSA M.D.
Provider Business Mailing Address
First Line : 305 TYSON AVE
Second Line :
City : PARIS
State : TN
Zip : 38242-4579
Country : US
Telephone Number : 731-642-0025
Fax Number : 731-644-0899
Provider Business Practice Location Address
First Line : 305 TYSON AVE
Second Line :
City : PARIS
State : TN
Zip : 38242-4579
Country : US
Telephone Number : 731-642-0025
Fax Number : 731-644-0899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2005
Last Update Date : 01/21/2013

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