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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417952144 NPPES
Colorado MEDICAID 01332295

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