Provider Demographics
NPI:1184063497
Name:VINSON, KENT RICHARD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KENT
Middle Name:RICHARD
Last Name:VINSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7612 CANTRELL RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-3320
Mailing Address - Country:US
Mailing Address - Phone:501-227-0587
Mailing Address - Fax:501-227-0714
Practice Address - Street 1:7612 CANTRELL RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-3320
Practice Address - Country:US
Practice Address - Phone:501-227-0587
Practice Address - Fax:501-227-0714
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD10567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist