Organization
VICK SURGICAL LLC
Active
Other names
Vick Surgical
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA VICK PA (OWNER)
(225) 413-5637
Entity
Organization
Contact information
Practice address
7777 HENNESSY BLVD STE 2004, BATON ROUGE, LA 70808-4370
(225) 769-2500
Mailing address
PO BOX 80112, BATON ROUGE, LA 70898-0112
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2568639
—
LA
Enumeration date
08/28/2023
Last updated
08/28/2023
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