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NPI Code Detail

MEDICARE: DR. THOMAS HENRY VINCENT II D.P.M.

MEDICARE: DR. THOMAS HENRY VINCENT II D.P.M.
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
1213E00000XPodiatristE3864CA
2213ES0103XFoot & Ankle Surgery PodiatristE3864CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2480015952OTHERCARAILROAD 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
3RHC140373OTHERCARADIOGRAPHY

General Provider Information

NPI Number : 1881621639
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS HENRY VINCENT II D.P.M.
Provider Business Mailing Address
First Line : 620 W TEFFT ST
Second Line :
City : NIPOMO
State : CA
Zip : 93444-9187
Country : US
Telephone Number : 805-929-8055
Fax Number : 805-929-8066
Provider Business Practice Location Address
First Line : 620 W TEFFT ST
Second Line :
City : NIPOMO
State : CA
Zip : 93444-9187
Country : US
Telephone Number : 805-929-8055
Fax Number : 805-929-8066
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 03/07/2023

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