Grant, Vincent L
Grant, Vincent L is an sole proprietor health care provider with primary practice located at 57 Dewey St , Lucedale MS 39452-5707. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Grant, Vincent L can be contacted via phone (601) 766-0308.Contact Information
Primary practice address
57 Dewey St
Lucedale MS 39452-5707
Phone: (601) 766-0308
Fax: (601) 766-0309
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | ME48804 | Florida |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 16759 | Mississippi |
Profile Details
| NPI number | 1073597092 |
|---|---|
| LBN Legal business name | Grant, Vincent L |
| Credentials | MD PLC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 2nd, 2005 |
| Last updated | Sep 27th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073597092 | NPPES |
| Mississippi | MEDICAID | 00122104 |
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