EUGENE TAD VICKERS (NPI# 1114098563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114098563 |
Entity Type | Individual |
Full Name | EUGENE TAD VICKERS |
Credential | PA |
Practice Address |
511 Morris Street Charleston WV 25301 |
Mailing Address |
Po Box 4009 Charleston WV 25364 |
Practice Telephone | 3043410511 |
Practice Fax Number | 3043410197 |
Mailing Telephone | 3043481288 |
Mailing Fax Number | 3043481262 |
Enumeration Date | 2006-11-09 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
00187 | WV | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
511 MORRIS STREET |
City | CHARLESTON |
State | WV |
Zip Code | 25301 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659382703 | Highland Behavioral Health Services Inc | Clinic/Center | 511 Morris Street, Charleston, WV 25301 | 2006-08-11 |
1225102023 | William R Hall | Psychologist | 511 Morris Street, Charleston, WV 25301 | 2006-11-20 |
1770661001 | Michael Pauley | Social Worker | 511 Morris Street, Charleston, WV 25301 | 2006-11-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669087680 | Kerrie Rena Harris | Counselor | 16 Leon Sullivan Way Suite 300, Charleston, WV 25301 | 2020-09-15 |
1285123471 | Burgess Dental | Dentist | 405 Capitol Street, The Parlor Suite, Charleston, WV 25301 | 2018-05-03 |
1104322320 | Kara Caldwell | Psychologist | 333 Laidley St., 4'th Floor East, Charleston, WV 25301 | 2018-04-05 |
1740638022 | Christina Phalen | Pharmacy Technician | 701 Lee Street East, Charleston, WV 25301 | 2016-05-27 |
1366867079 | Brooke Powell Garnes | Speech-Language Pathologist | 1313 Quarrier Street, Suite A, Charleston, WV 25301 | 2014-03-04 |
1952648404 | Implanted Pump Management, LLC | Home Infusion | 311 Laidley St., Suite 202, Charleston, WV 25301 | 2013-01-03 |
1730435108 | Chaitanya Mishra | Internal Medicine | 501 Morris St Ste 357, Charleston, WV 25301 | 2012-08-03 |
1033477278 | James Stephen Harman | Neurological Surgery | 415 Morris St Ste 400, Charleston, WV 25301 | 2012-04-25 |
1265674329 | Howard and Howard Dental LLC | Dentist | 1321 Virginia St., Charleston, WV 25301 | 2009-04-03 |
1881856144 | Steven David Hollosi | Emergency Medicine | 501 Morris St., Charleston, WV 25301 | 2008-06-27 |
Find all providers in zip 25301 |
Taxonomy Code | 364SP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Clinical Nurse Specialist |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346451069 | Therese Kathleen Killeen | Clinical Nurse Specialist | 125 Doughty St, Suite 190, Charleston, SC 29403-5736 | 2007-05-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952300519 | Lois Rebecca Mcdonald | Clinical Nurse Specialist | 129 E. German St., Office #206, Sheperdstown, WV 25443 | 2005-07-17 |
1275997686 | Lesia Darlene Gibson | Clinical Nurse Specialist | 527 Medical Park Dr Ste 105, Bridgeport, WV 26330-9009 | 2016-04-12 |
City | CHARLESTON |
Zip Code | 25301 |
Please comment or provide details below to improve the information on EUGENE TAD VICKERS.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.