Vickar, Garry Martin
Vickar, Garry Martin is an individual health care provider with primary practice located at 11125 Dunn Road Suite 213, St Louis MO 63136-6132. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Vickar, Garry Martin can be contacted via phone (314) 837-4900.Contact Information
Primary practice address
11125 Dunn Road Suite 213
St Louis MO 63136-6132
Phone: (314) 837-4900
Fax: (314) 837-5646
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | R5051 | Missouri |
Profile Details
NPI number | 1366402612 |
---|---|
LBN Legal business name | Vickar, Garry Martin |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 23rd, 2006 |
Last updated | Mar 12th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1366402612 | NPPES |
Missouri | MEDICAID | 200794402 |
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