Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK D VICK, MD
Active Sole ProprietorJACK D VICK, MD is a Family Medicine healthcare provider located in FORT SUMNER, New Mexico. NPI 1538242219 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · FORT SUMNER, NM
Registration Details
- NPI Number
- 1538242219
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 24, 2006 (19.776380948996 yrs)
- Last Updated
- May 19, 2009
- License
-
92371 (NM)
- Sole Proprietor
- Yes
Practice Information
- Address
-
546 N. 10TH STREETFORT SUMNER, NM, 881190349Browse NM providers · Browse ZIP 88119
- Phone
- 5753552414
- Fax
- 5753557894
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in FORT SUMNER, NM
| Name | Credential | NPI |
|---|---|---|
| CAROLYN KAY CARAWAY | FNP | 1306832019 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.