Provider Demographics
NPI:1114973278
Name:VINSON, ERIC D (DO)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:D
Last Name:VINSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4372 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:KANE
Mailing Address - State:PA
Mailing Address - Zip Code:16735-3099
Mailing Address - Country:US
Mailing Address - Phone:814-837-4560
Mailing Address - Fax:814-837-7905
Practice Address - Street 1:4372 ROUTE 6
Practice Address - Street 2:
Practice Address - City:KANE
Practice Address - State:PA
Practice Address - Zip Code:16735-3099
Practice Address - Country:US
Practice Address - Phone:814-837-4560
Practice Address - Fax:814-837-7905
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013117207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine