Vincent, Jared Mark

Vincent, Jared Mark is an sole proprietor health care provider with primary practice located at 400 E Vaughn Ave , Ruston LA 71270-5951. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Vincent, Jared Mark can be contacted via phone (318) 251-0620.

Contact Information

Primary practice address
400 E Vaughn Ave Ruston LA 71270-5951
Phone: (318) 251-0620
Fax: (318) 251-0621
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 025302 Louisiana

Profile Details

NPI number 1639167836
LBN Legal business name Vincent, Jared Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 11th, 2005
Last updated Jan 26th, 2012 - about 13 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 1639167836 NPPES
Louisiana Other 208916544 FEDERAL TAX IDENTIFICATION NUMBER
Louisiana Other 5CY25 FEDERAL TAX IDENTIFICATION NUMBER
Louisiana Other 1619189362 FEDERAL TAX IDENTIFICATION NUMBER
Louisiana MEDICAID 1578967 FEDERAL TAX IDENTIFICATION NUMBER
Louisiana Other 1639167836 FEDERAL TAX IDENTIFICATION NUMBER

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