Individual
GREGORY CHARLTON VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
225 MEDICAL CENTER DR, SUITE 105, PADUCAH, KY 42003-7914
(270) 441-4500
(270) 441-4289
Mailing address
PO BOX 636961, CINCINNATI, OH 45263-6961
(513) 981-5130
(513) 981-5015
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3002028
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74002775
—
KY
Enumeration date
07/17/2006
Last updated
08/31/2015
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