Individual
BRUCE S VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
444 CLINCHFIELD ST STE 2500, KINGSPORT, TN 37660-3858
(423) 230-2500
(423) 230-2510
Mailing address
444 CLINCHFIELD ST, SUITE 201, KINGSPORT, TN 37660-3858
(423) 230-2500
(423) 230-2510
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD27961
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1337280
BLACK LUNG
TN
01
—
209176
UMWA
TN
01
—
281048
BLUE CROSS BLUE SHIELD
VA
05
—
3804526
—
TN
01
—
4095899
BLUE CROSS BLUE SHIELD
TN
01
—
5619840
MEDICAID
VA
01
—
62158439125
JOHN DEERE
TN
01
—
CA4007
MEDICARE RAILROAD
TN
Enumeration date
05/15/2006
Last updated
12/05/2020
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