Individual
JON L VICKERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
417 VILLAGE DR, SUITE 6, CARLISLE, PA 17013-6945
(717) 245-2226
(717) 245-0316
Mailing address
417 VILLAGE DR, SUITE 6, CARLISLE, PA 17013-6945
(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
04/19/2006
Last updated
02/19/2008
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