Diane M Vickery, MD
Individual provider Active NPI Neurology Physician · Seaman, OH
NPI 1922058015 · NPPES record last updated Mar 31, 2010
Key facts
- NPI
- 1922058015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology Physician 2084N0400X
- License
- 35-04-3357 (OH)
- Practice address
- 230 Medical Center Dr
C/O Acrmc Outpatient Clinic
Seaman, OH 45679-8002 - Phone
- (937) 386-3420
- Fax
- (937) 386-3439
- NPI assigned
- May 11, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 35-04-3357 | OH | Yes |
Addresses
Primary practice location
230 Medical Center Dr
C/O Acrmc Outpatient Clinic
Seaman, OH 45679-8002
Mailing address
230 Medical Center Dr
C/O Acrmc Outpatient Clinic
Seaman, OH 45679-8002
Phone (937) 386-3420
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0460826 | Medicaid | OH |
Other providers in Seaman, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2010. 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.