Individual
DR. BRAD DAVID VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10310 THE GROVE BLVD, BATON ROUGE, LA 70836-6455
(225) 761-5200
(225) 754-5030
Mailing address
10310 THE GROVE BLVD, BATON ROUGE, LA 70836-6455
(225) 761-5200
(225) 754-5030
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
201519
LA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
22768
SC
207RP1001X
Pulmonary Disease Physician
Primary
201519
LA
207RP1001X
Pulmonary Disease Physician
22768
SC
207RP1001X
Pulmonary Disease Physician
MED-PHYS-LIC-98295
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08156769
—
MS
05
—
1023639
—
LA
Enumeration date
10/23/2006
Last updated
02/28/2023
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