Individual
VERNON A VIX JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
421 CHESTNUT ST, EVANSVILLE, IN 47713-1227
(812) 474-7123
(812) 858-4545
Mailing address
PO BOX 3868, EVANSVILLE, IN 47737-3868
(812) 474-7123
(812) 858-4545
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01037267A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000109456
INDIANA ANTHEM
IN
05
—
100088450
—
IN
01
—
64870207
KY MEDICAID
KY
Enumeration date
12/04/2006
Last updated
01/09/2013
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