Vincent, Jacob William

Vincent, Jacob William is an individual health care provider with primary practice located at 3615 E John Rowan Blvd Ste 104 , Bardstown KY 40004-3264. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Vincent, Jacob William can be contacted via phone (502) 348-5968.

Contact Information

Primary practice address
3615 E John Rowan Blvd Ste 104 Bardstown KY 40004-3264
Phone: (502) 348-5968
Fax: (270) 706-5802
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 34239 Kentucky

Profile Details

NPI number 1629075692
LBN Legal business name Vincent, Jacob William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2005
Last updated Mar 4th, 2024 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629075692 NPPES
Kentucky MEDICAID 64014111

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