Individual
MR. BERTRAM VINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
334 TIFTON ELDORADO RD, TIFTON, GA 31794-9497
(229) 391-2300
(229) 386-3221
Mailing address
3120 N OAK STREET EXT STE C, VALDOSTA, GA 31602-5910
(229) 671-6100
(229) 671-6774
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
135412
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135412
LICENSE NUMBER
GA
Enumeration date
04/12/2011
Last updated
04/12/2011
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