Individual
DOUGLAS TODD VICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
710 SUNSET BLVD N STE A, SUNSET BEACH, NC 28468-4340
(910) 663-2273
(910) 663-4050
Mailing address
PO BOX 2123, BRYSON CITY, NC 28713-5123
(910) 490-0490
(828) 538-4441
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102728
NC
363A00000X
Physician Assistant
PA555
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043385123
—
NC
05
—
1925PA
—
SC
Enumeration date
11/22/2006
Last updated
05/06/2026
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