Vickery, Brock
Vickery, Brock is an individual health care provider with primary practice located at 1400 E Boulder St , Colorado Springs CO 80909-5533. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Vickery, Brock can be contacted via phone (719) 365-1229.Contact Information
Primary practice address
1400 E Boulder St
Colorado Springs CO 80909-5533
Phone: (719) 365-1229
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 33229 | Colorado |
Profile Details
| NPI number | 1417952144 |
|---|---|
| LBN Legal business name | Vickery, Brock |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2005 |
| Last updated | Mar 23rd, 2016 - about 8 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 | 1417952144 | NPPES |
| Colorado | MEDICAID | 01332295 |
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