Provider Demographics
NPI:1558426866
Name:VINSON, DONALD G (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:G
Last Name:VINSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1971 GA HIGHWAY 122
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31757-2500
Mailing Address - Country:US
Mailing Address - Phone:229-226-5094
Mailing Address - Fax:
Practice Address - Street 1:1971 GA HIGHWAY 122
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31757-2500
Practice Address - Country:US
Practice Address - Phone:229-226-5094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2989111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCHDJMedicare PIN
GAU16837Medicare UPIN