Provider Demographics
NPI:1578715900
Name:LARKIN, VINCENT DEPAUL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:DEPAUL
Last Name:LARKIN
Suffix:JR
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 1:205 SUGARBUSH RD
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:PA
Mailing Address - Zip Code:18414-9542
Mailing Address - Country:US
Mailing Address - Phone:570-563-2843
Mailing Address - Fax:
Practice Address - Street 1:205 SUGARBUSH RD
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:PA
Practice Address - Zip Code:18414
Practice Address - Country:US
Practice Address - Phone:570-563-2843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022999E2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232207314Medicare UPIN