# DOUGLAS E. VICK, DO M. TAMARIN VICK, DO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982875050
- **Authorized official:** MARY TAMARIN VICK D.O. (PRACTITIONER)
- **Authorized official phone:** (859) 873-8044

## Contact information

- **Practice address:** 208 CROSSFIELD DR, VERSAILLES, KY 40383-1468
- **Practice address phone:** (859) 873-8044
- **Practice address fax:** (859) 873-8045
- **Mailing address:** 208 CROSSFIELD DR, VERSAILLES, KY 40383-1468
- **Mailing address phone:** (859) 873-8044
- **Mailing address fax:** (859) 873-8045

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 02382 | KY | Yes |
| 207Q00000X | Family Medicine Physician | 02382 | KY | — |
| 208D00000X | General Practice Physician | 02383 | KY | — |

## Other

- **Enumeration date:** 03/17/2008
- **Last updated:** 03/17/2008