Organization
VICKERY NEURODIAGNOSTICS GROUP LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON L VICKERY M.D. (PRESIDENT)
(717) 245-2226
Entity
Organization
Contact information
Practice address
3 JENNIFER CT, SUITEB, CARLISLE, PA 17015-7791
(717) 245-2226
(717) 245-0316
Mailing address
3 JENNIFER CT, SUITEB, CARLISLE, PA 17015-7791
(717) 245-2226
(717) 245-0316
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD031004E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014792300003
—
PA
Enumeration date
11/22/2006
Last updated
12/08/2014
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