Individual
PRAVEEN VIKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 S MAIN ST, MCCREERY CANCER CENTER, FAIRFIELD, IA 52556-9572
(641) 472-4111
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1007
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
39452
IA
207RX0202X
Medical Oncology Physician
Primary
39452
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1507038
—
TN
05
—
7100050810
—
KY
Enumeration date
09/14/2007
Last updated
07/02/2015
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