Provider Demographics
NPI:1407822711
Name:VINSON, JAMES H (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:VINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 51883
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37950-1883
Mailing Address - Country:US
Mailing Address - Phone:865-766-8897
Mailing Address - Fax:865-766-8874
Practice Address - Street 1:907 E LAMAR ALEXANDER PKWY
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-5015
Practice Address - Country:US
Practice Address - Phone:865-981-2335
Practice Address - Fax:865-694-4339
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16912207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64778657Medicaid
TN100010696OtherPHP CARITEN
TNPT26300OtherUHC
TN166689000OtherDOL
TN3044553Medicaid
TN4011789OtherBCBS OF TN
TN100010696OtherPHP CARITEN
TND93636Medicare UPIN
TN166689000OtherDOL