Marvin Haber Vickers Jr., M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD9229 Issued in TN

Practice address

2227 Breakwater Dr
Knoxville, TN 37922-5678

Phone

(865) 675-2890

NPI assigned

Aug 31, 2006

Last updated

Apr 7, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71045

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premier Surgical Associates, PLLC

  • Prosthetic/Orthotic Supplier
  • Knoxville, TN
  • NPI 1285806919

  Surgery

  NPD (past)
• Premier Surgical Associates, PLLC

  • Surgery Physician
  • Knoxville, TN
  • NPI 1750449443
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1649381864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2227 BREAKWATER DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379225678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2227 BREAKWATER DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379225678",
            "telephone_number": "865-675-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "MARVIN",
        "middle_name": "HABER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD9229",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "MD9229",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincent Antonio Vetrano, MD
• Mary Kelly Vicars, PHARMD
• Matthew Jonathan Vicars, PHARMD
• Jonathan D Vice, CRNA
• George Wilson Vick II, M.D.
• Daniel Vickery, AGCNS-BC
• Victor Hubbell Williams LLC (Knoxville Dental Center)
• Victor Hubbell Williams PLLC (Morristown Dentistry)
• Victory Orthotics & Prosthetics LLC
• Victory Treatment Program, LLC (Maltman Medical Center)

• Surgery Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.