Basic Information
| Provider Information | |||||||||
| NPI: | 1538322862 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VANN | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 ARROWHEAD TRL | ||||||||
| Address2: | |||||||||
| City: | GADSDEN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 359018626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059108461 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1007 GOODYEAR AVE | ||||||||
| Address2: | |||||||||
| City: | GADSDEN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 359031195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2564944100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2008 | ||||||||
| LastUpdateDate: | 02/14/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 30100 | AL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.