# DR. AMANDA M VICKERS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1770925794
- **Gender:** F
- **Credential:** D.O

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 05530 | KY | Yes |
| 207Q00000X | Family Medicine Physician | 2018036866 | MO | — |
| 207Q00000X | Family Medicine Physician | Q1323 | TX | — |

## Other

- **Enumeration date:** 07/18/2013
- **Last updated:** 03/05/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200064469 | — | MO |