Individual
DR. VINCENT GREGORY TICHENOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 E PRIMROSE ST, SPRINGFIELD, MO 65807-5154
(417) 269-9812
(417) 269-9853
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125.063612
IL
207Q00000X
Family Medicine Physician
Primary
2020017666
MO
Other
Enumeration date
06/13/2013
Last updated
07/13/2020
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