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Individual
BRUCE S VINCENT
Active
Individual
BRUCE S VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD27961
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1337280
BLACK LUNG
TN
01
—
209176
UMWA
TN
01
—
281048
BLUE CROSS BLUE SHIELD
VA
05
—
3804526
—
TN
01
—
4095899
BLUE CROSS BLUE SHIELD
TN
01
—
5619840
MEDICAID
VA
01
—
62158439125
JOHN DEERE
TN
01
—
CA4007
MEDICARE RAILROAD
TN
Enumeration date
05/15/2006
Last updated
12/05/2020
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