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
Fax: (314) 837-5646
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366402612 NPPES
Missouri MEDICAID 200794402

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