Individual
MARK N VINZANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1410 N WOODLAWN BLVD, SUITE A, DERBY, KS 67037-2922
(316) 788-3741
(316) 788-5198
Mailing address
1410 N WOODLAWN BLVD, SUITE A, DERBY, KS 67037-2922
(316) 788-3741
(316) 788-5198
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0417161
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006432
BC/BS
KS
Enumeration date
06/03/2006
Last updated
06/23/2008
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