Provider Demographics
NPI:1851698310
Name:VINCENTIAN PHYSICIAN SERVICES LLC
Entity type:Organization
Organization Name:VINCENTIAN PHYSICIAN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SUMMER
Authorized Official - Middle Name:
Authorized Official - Last Name:TAPPAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-939-7230
Mailing Address - Street 1:PO BOX 55309
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5309
Mailing Address - Country:US
Mailing Address - Phone:205-939-2900
Mailing Address - Fax:877-575-1089
Practice Address - Street 1:810 SAINT VINCENT'S DRIVE
Practice Address - Street 2:3RD FLOOR; PHYSICIAN DEVELOPMENT DEPT
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1601
Practice Address - Country:US
Practice Address - Phone:205-930-2346
Practice Address - Fax:205-930-2158
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VINCENTIAN VENTURES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-18
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty