Organization
ICI 24 7 PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALIX VINCENT MD (PRESIDENT)
(949) 480-9692
Entity
Organization
Contact information
Practice address
727 N MAIN ST, EMPORIA, VA 23847-1274
(434) 348-4400
(434) 348-4945
Mailing address
75 REMITTANCE DR DEPT 6597, DEPT 6597, CHICAGO, IL 60675-6597
(951) 786-0801
(855) 226-5960
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
06/06/2011
Last updated
05/07/2015
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