Individual
MR. BRIAN SCOTT VICKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(706) 882-1411
(706) 845-3459
Mailing address
3025 HIGHWAY 154, BLDG B, NEWNAN, GA 30265-6121
(770) 251-2060
(770) 251-8567
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN204160
GA
Other
Enumeration date
02/22/2010
Last updated
01/27/2021
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