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Organization

DOUGLAS E. VICK, DO M. TAMARIN VICK, DO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY TAMARIN VICK D.O. (PRACTITIONER)
(859) 873-8044
Entity
Organization

Contact information

Practice address
208 CROSSFIELD DR, VERSAILLES, KY 40383-1468
(859) 873-8044
(859) 873-8045
Mailing address
208 CROSSFIELD DR, VERSAILLES, KY 40383-1468
(859) 873-8044
(859) 873-8045

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
02382
KY
207Q00000X
Family Medicine Physician
02382
KY
208D00000X
General Practice Physician
02383
KY

Other

Enumeration date
03/17/2008
Last updated
03/17/2008
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