Basic Information
| Provider Information | |||||||||
| NPI: | 1942540950 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VINCENT VEIN CENTER DENVER PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7600 PARK MEADOWS DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LONETREE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801242560 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037995199 | ||||||||
| FaxNumber: | 3037996634 | ||||||||
| Practice Location | |||||||||
| Address1: | 7600 PARK MEADOWS DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LONETREE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801242560 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037995199 | ||||||||
| FaxNumber: | 3037996634 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2013 | ||||||||
| LastUpdateDate: | 02/28/2013 | ||||||||
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| AuthorizedOfficialLastName: | VINCENT | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3037995199 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.