Individual
DR. VINCENT PUCCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1818 N 6TH ST, TERRE HAUTE, IN 47804-4021
(812) 232-1123
(812) 232-1409
Mailing address
1818 N 6TH ST, TERRE HAUTE, IN 47804-4021
(812) 232-1123
(812) 232-1409
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01042714
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020024123
MEDICARE RAILROAD
IN
05
—
100373320A
—
IN
Enumeration date
06/02/2005
Last updated
11/17/2009
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