| Doctor Name: | MR. JOHN C VINSON IV |
| NPI Number: | 1891874780 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APRN |
| License Number: | 4981P |
| Business Practice Address: | 1060 Grand Ave Beattyville, KY - 41311 |
| Business Phone Number: | 6064643212 |
| Business Fax Number: | 6064640234 |
| Mailing Address: | 115 Rockwood Ln, HAZARD |
| State: | KY |
| Postal Code: | 417019415 |
| Phone Number: | 6064365761 |
| Fax Number: | 6064365797 |
| NPI Enumeration Date: | 11/03/2006 |
| NPI Last Update Date: | 05/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0808X |
| License Number: | 4981P |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |