Individual
JOSHUA LANDON VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 DOCTORS DR STE I, DOUGLAS, GA 31533-2211
(912) 383-6575
(912) 383-6476
Mailing address
100 DOCTORS DR STE I, DOUGLAS, GA 31533-2211
(912) 383-6575
(912) 383-6476
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
TRN17312
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003191614A
—
GA
01
—
077804
MEDICAL LICENSE
GA
Enumeration date
05/16/2012
Last updated
04/27/2019
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