| Doctor Name: | DOUGLAS E VICK |
| NPI Number: | 1326261892 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 02382 |
| Business Practice Address: | 208 Crossfield Dr Versailles, KY - 403831468 |
| Business Phone Number: | 8598738044 |
| Business Fax Number: | 8598738045 |
| Mailing Address: | 208 Crossfield Dr, VERSAILLES |
| State: | KY |
| Postal Code: | 403831468 |
| Phone Number: | 8598738044 |
| Fax Number: | 8598738045 |
| NPI Enumeration Date: | 04/11/2007 |
| NPI Last Update Date: | 01/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | 02382 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |