Individual
THOMAS BLAKE VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3400 NEW HARTFORD RD, OWENSBORO, KY 42303-2058
(270) 684-5034
Mailing address
PO BOX 1244, HENDERSON, KY 42419-1244
(812) 465-6202
(812) 474-3622
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03709
KY
207Q00000X
Family Medicine Physician
R3058
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201324850
—
IN
05
—
7100282830
—
KY
Enumeration date
06/27/2013
Last updated
11/06/2024
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