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Provider Information

Ethnicity

If you wish to add more than one additional language, please email providernetworkdevelopment@vsp.com.

Provider Gender
Provider Type
Special services offered by doctor:

Primary Practice Information

Do you have your own professional liability insurance of at least $1 million per occurrence / $3 million aggregate?
Are you registered with CAQH? (Council For Affordable Quality Healthcare)?
Are you a US Veteran?
Are you: (check all that apply)
Check Premier Edge Status