Vickers, Mitchael Lee

Vickers, Mitchael Lee is an individual health care provider with primary practice located at 2500 Hospital Blvd Suite 480, Roswell GA 30076-4975. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Vickers, Mitchael Lee can be contacted via phone (678) 762-0676.

Contact Information

Primary practice address
2500 Hospital Blvd Suite 480 Roswell GA 30076-4975
Phone: (678) 762-0676
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN141647 Georgia

Profile Details

NPI number 1437128857
LBN Legal business name Vickers, Mitchael Lee
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Nov 18th, 2010 - about 16 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 1437128857 NPPES
Other P00232387 RR MEDICARE
MEDICAID 000806242M RR MEDICARE

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