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Individual

CHRISTOPHER L VICKERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
340 N BELAIR RD, EVANS, GA 30809-3000
(706) 868-5676
(706) 722-2824
Mailing address
340 N BELAIR RD, EVANS, GA 30809-3000
(706) 868-5676
(706) 722-2824

Taxonomy

Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
034487
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000724006G
GA
01
157315300
EMPLOYMENT STANDARD
01
5446256
AETNA
01
8202549
CIGNA
01
940261
BLUE CROSS
GA
01
P00201658
MEDICARE RAILROAD
GA
Enumeration date
02/27/2006
Last updated
01/06/2010
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