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Individual

MARTYN A VICKERS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3 GLEN COVE DR, ROCKPORT, ME 04856-4232
(207) 593-5400
(207) 593-5301
Mailing address
3 GLEN COVE DR, ROCKPORT, ME 04856-4232
(207) 593-5400
(207) 593-5301

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
006250
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10450000
ME
Enumeration date
09/21/2006
Last updated
07/08/2007
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