Individual
DR. JOHN RANDOLPH VANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 PARK CREEK DR, GREENVILLE, SC 29605-4270
(864) 234-7654
(864) 675-1657
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(803) 434-6485
(864) 675-1657
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
10571
SC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
10571
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105718
—
SC
Enumeration date
05/01/2006
Last updated
12/14/2022
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