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Individual

DR. BARON VANCE HERFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1 MEDICAL CENTER BLVD, COOKEVILLE, TN 38501-4294
(931) 372-2770
(931) 525-1176
Mailing address
401 ALCORN DR, SUITE 2C, CORINTH, MS 38834-9072
(662) 286-9255
(662) 286-9274

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20998
MS
208M00000X
Hospitalist Physician
Primary
2847
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05005793
MS
01
302I116832
MEDICARE
MS
01
P00951695
RAILROAD MEDICARE
MS
Enumeration date
04/13/2010
Last updated
09/10/2018
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