Provider Demographics
NPI:1316943525
Name:VINSON, CARL L (OD)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:L
Last Name:VINSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-3535
Mailing Address - Country:US
Mailing Address - Phone:615-895-5000
Mailing Address - Fax:615-895-5500
Practice Address - Street 1:401 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-3535
Practice Address - Country:US
Practice Address - Phone:615-895-5000
Practice Address - Fax:615-895-5500
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT1569152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN003006597OtherBCBS OF TN
TN3599475Medicaid
TN2240296OtherUNITED HEALTHCARE
TN1052460001Medicare NSC
TN2240296OtherUNITED HEALTHCARE