Individual
DAVID E VICKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13050 PARKSIDE DR STE 101, FISHERS, IN 46038-8247
(317) 621-2290
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
(317) 355-2184
(317) 355-7750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01030402A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100127590
—
IN
Enumeration date
07/24/2006
Last updated
11/15/2022
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