Individual
ROBERT VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2618 SOUTH AVE W, MISSOULA, MT 59804-6406
(406) 327-4640
Mailing address
PO BOX 16900, MISSOULA, MT 59808-6900
(406) 327-4640
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10257
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0151334
—
MT
Enumeration date
10/02/2006
Last updated
07/08/2007
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