Provider Demographics
NPI:1972079978
Name:VINSON, PHD, JAMES L (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:VINSON, PHD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3564 WESLEY CHAPEL RD STE E
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-5254
Mailing Address - Country:US
Mailing Address - Phone:470-448-3001
Mailing Address - Fax:770-558-6052
Practice Address - Street 1:4050 SNAPFINGER WOODS DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035
Practice Address - Country:US
Practice Address - Phone:470-448-3001
Practice Address - Fax:770-558-6052
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No374U00000XNursing Service Related ProvidersHome Health Aide