Individual
DR. JOHN EDWARD VICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
701 HOSPITAL LOOP, SUITE 306, FAIRCHILD AFB, WA 99011-8704
(509) 247-2361
Mailing address
701 HOSPITAL LOOP, SUITE 306, FAIRCHILD AFB, WA 99011-8704
(509) 247-2361
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
55670-020
WI
Other
Enumeration date
03/24/2009
Last updated
09/02/2014
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