Individual
LISA L VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7575 5 MILE RD, CINCINNATI, OH 45230-4346
(513) 981-6784
(513) 232-2522
Mailing address
7575 5 MILE RD, CINCINNATI, OH 45230-4346
(513) 981-6784
(513) 232-2522
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
64003
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
382018
—
OH
Enumeration date
08/09/2005
Last updated
10/09/2020
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