Individual
JASMINE VICKERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-6503
(215) 349-5910
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(248) 421-0825
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD484405
PA
Other
Enumeration date
04/01/2019
Last updated
01/28/2025
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