| Joseph W Vick Roy Jr Md Pc | |
|
1200 E 3900 S Salt Lake City UT 84124-1300 | |
| (801) 293-6823 | |
| (801) 293-6828 |
| Full Name | Joseph W Vick Roy Jr Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1200 E 3900 S, Salt Lake City, Utah |
| Authorized Official Name and Position | Joseph W Vickroy (PRESIDENT) |
| Authorized Official Contact | 8012936823 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph W Vick Roy Jr Md Pc 2708 Gallivan Loop Park City UT 84060-7074 Ph: (801) 599-1750 | Joseph W Vick Roy Jr Md Pc 1200 E 3900 S Salt Lake City UT 84124-1300 Ph: (801) 293-6823 |
| NPI Number | 1639385438 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 08/05/2024 |
| Certification Date | 08/05/2024 |
| Medicare PECOS PAC ID | 1456426949 |
|---|---|
| Medicare Enrollment ID | O20100211000725 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639385438 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 183895-1205 (Utah) | Primary |
| Provider Name | Joseph W Vick Roy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104818442 PECOS PAC ID: 2567505647 Enrollment ID: I20100211000716 |
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