# DR. VINCENT JOHN HETHERINGTON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1679570964
- **Gender:** Man
- **Credential:** D.P.M.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 36002554 | OH | Yes |

## Other

- **Enumeration date:** 07/01/2005
- **Last updated:** 02/08/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0728476 | — | OH |
| 05 | — | 1563848 | — | OH |
| 01 | — | 480031328 | RR MEDICARE | OH |
| 01 | — | CH5179 | RR MEDICARE GROUP | OH |