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Individual
MRS. CARLIN BORDEN VICKERY
Active
Individual
MRS. CARLIN BORDEN VICKERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
144463
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N27472
HEALTH NET
NY
01
—
P621719
OXFORD
NY
Enumeration date
08/30/2006
Last updated
07/08/2007
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