Provider Demographics
NPI:1609845536
Name:VINH, PIERRE K (OD)
Entity Type:Individual
Prefix:DR
First Name:PIERRE
Middle Name:K
Last Name:VINH
Suffix:
Gender:M
Credentials:OD
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 28781
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31221-8781
Mailing Address - Country:US
Mailing Address - Phone:845-235-3665
Mailing Address - Fax:478-254-6625
Practice Address - Street 1:5080 RIVERSIDE DR
Practice Address - Street 2:SUITE 400
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1100
Practice Address - Country:US
Practice Address - Phone:478-474-3330
Practice Address - Fax:478-474-3722
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002267152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist