Individual
TIMOTHY MCVICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3555 OLENTANGY RIVER RD, COLUMBUS, OH 43214-3912
(614) 268-8164
Mailing address
2134 YELLOW PINE AVE, COLUMBUS, OH 43229-4622
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.007763RX
OH
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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