Shaw, Vincent Lee
Shaw, Vincent Lee is an individual health care provider with primary practice located at 8490 Picardy Ave Bldg 100 Ste A, Baton Rouge LA 70809-3731. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Shaw, Vincent Lee can be contacted via phone (225) 819-1170.Contact Information
Primary practice address
8490 Picardy Ave Bldg 100 Ste A
Baton Rouge LA 70809-3731
Phone: (225) 819-1170
Fax: (225) 819-1179
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 026422 | Louisiana |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 026422 | Louisiana |
Profile Details
| NPI number | 1154356491 |
|---|---|
| LBN Legal business name | Shaw, Vincent Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Aug 30th, 2022 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154356491 | NPPES |
| Louisiana | MEDICAID | 1058823 | |
| Louisiana | Other | 026422 | |
| Louisiana | Other | 4J728YJGU |
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