Provider Demographics
NPI:1730155813
Name:DEVLIN, VINCENT J (MD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:J
Last Name:DEVLIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14024 QUAIL POINTE DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1006
Mailing Address - Country:US
Mailing Address - Phone:405-419-8420
Mailing Address - Fax:405-419-8460
Practice Address - Street 1:3115 SW 89TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7901
Practice Address - Country:US
Practice Address - Phone:405-424-5630
Practice Address - Fax:405-692-1632
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK26404207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101164996Medicaid
AZ117072Medicare PIN
E49649Medicare UPIN
OKOK400749Medicare PIN