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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 6 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 1073597092 NPPES
Mississippi MEDICAID 00122104

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