Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 21575 | KY |
NPI | 1023068368 |
---|---|
Provider Name | Dr. John Charles Vance |
First Address | Lexington, KY 40503-1471 |
Second Address | Lexington, KY 40503-1471 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 06/08/2008 |