Individual
GEORGE O'NEAL VINSANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
919 E. CENTRAL AVENUE, SUITE 201, LAFOLLETTE, TN 37766
(423) 907-1680
(423) 907-1684
Mailing address
919 E. CENTRAL AVENUE, SUITE 201, LAFOLLETTE, TN 37766
(423) 907-1680
(423) 907-1684
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0000018128
TN
2086S0129X
Vascular Surgery Physician
MD18128
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000018128
MEDICAL LICENSE
TN
01
—
320052634
TAX ID
TN
01
—
4052243
BLUE CROSS BLUE SHIELD
TN
Enumeration date
09/27/2006
Last updated
03/07/2023
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