Individual
DAVID B VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1521 W 13TH ST, CLOVIS, NM 88101-5568
(575) 769-0888
Mailing address
PO BOX 843, PORTALES, NM 88130-0843
(575) 356-6695
(575) 356-5948
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
99-321
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0612426-03
—
NM
05
—
74435
—
NM
Enumeration date
10/04/2006
Last updated
06/13/2024
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