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Dr. Raymond Daniel Vickery, DO
General Practice Physician in Fort Moore, Georgia
NPI 1093444606

Raymond Daniel Vickery is a General Practice Physician based in Fort Benning, GA. Raymond Daniel Vickery practices in Fort Moore, GA and has the professional credentials of DO. The NPI Number for Raymond Daniel Vickery is 1093444606 and holds a License No. (Georgia).

The current practice location address for Raymond Daniel Vickery is 6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA and can be reached out via phone at 762-408-2532.

Location: 6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA, 31905-2102
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1093444606
Provider Name
Raymond Daniel Vickery
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA, 31905-2102
Phone Number
762-408-2532
Fax Number
Provider Enumeration Date
06/08/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
98041 01 GA MEDICAL LICENSE
institution
Provider Business Practice Location Address Details
Address
6600 Van Aalst Blvd Bldg 9250
City
Fort Moore
State
Georgia
Zip
31905-2102
Phone Number
762-408-2532
Fax Number
person
Provider Business Mailing Address Details
Address
6600 Van Aalst Blvd Bldg 9250
City
Fort Moore
State
Georgia
Zip
31905-2102
Phone Number
762-408-2532
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
98041 (Georgia)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
()
Definition
Definition to come...
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