David Vickers
Individual provider Active NPI Attendant Care Provider · Pearson, GA
NPI 1053962183 · NPPES record last updated Sep 20, 2019
Key facts
- NPI
- 1053962183
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Attendant Care Provider 3747A0650X
- Practice address
- 488 Austin Ave E
Pearson, GA 31642-8144 - Phone
- (912) 422-5600
- NPI assigned
- Sep 20, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | Yes |
Addresses
Primary practice location
488 Austin Ave E
Pearson, GA 31642-8144
Mailing address
488 Austin Ave E
Pearson, GA 31642-8144
Phone (912) 422-5600
Other providers in Pearson, GA
- South Central Primary Care Center, Inc
- Matthew Tanner
- Unison Behavioral Health
- Unison Behavioral Health
- Unison Behavioral Health
- Donna Kenyattia Wells
All providers in Pearson, GA · Attendant Care Provider in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.