Individual
DR. AMANDA M VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
309 11TH ST, CARROLLTON, KY 41008-1435
(502) 732-4321
Mailing address
309 11TH ST, CARROLLTON, KY 41008-1435
(502) 732-4321
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05530
KY
207Q00000X
Family Medicine Physician
2018036866
MO
207Q00000X
Family Medicine Physician
Q1323
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200064469
—
MO
Enumeration date
07/18/2013
Last updated
03/05/2025
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