Individual
DR. GARRY MARTIN VICKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11125 DUNN ROAD, SUITE 213, ST LOUIS, MO 63136-6132
(314) 837-4900
(314) 837-5646
Mailing address
11125 DUNN ROAD, SUITE 213, ST LOUIS, MO 63136-6132
(314) 837-4900
(314) 837-5646
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R5051
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200794402
—
MO
Enumeration date
03/23/2006
Last updated
03/12/2014
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