| David B Vickers, MD | |
|
1521 W 13th St, Clovis, NM 88101-5568 | |
| (575) 769-0888 | |
| Not Available |
| Full Name | David B Vickers |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 1521 W 13th St, Clovis, New Mexico |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649365826 | NPI | - | NPPES |
| 0612426-03 | Medicaid | NM | |
| 74435 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 99-321 (New Mexico) | Primary |
| Entity Name | La Casa De Buena Salud Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972603165 PECOS PAC ID: 9234032939 Enrollment ID: O20040129001141 |
| Mailing Address | Practice Location Address |
|---|---|
| David B Vickers, MD Po Box 843, Portales, NM 88130-0843 Ph: (575) 356-6695 | David B Vickers, MD 1521 W 13th St, Clovis, NM 88101-5568 Ph: (575) 769-0888 |
Dr. Salvatore La Fata, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2020 Sheffield Dr, Clovis, NM 88101 Phone: 505-762-4507 Fax: 505-762-7220 | |
Basil A Anaele, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1521 W 13th St, Clovis, NM 88101 Phone: 575-769-0888 Fax: 575-763-9154 | |
Adora Anudu, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2200 W 21st St, Clovis, NM 88101 Phone: 575-769-7577 Fax: 575-769-6329 | |
Chioma Muoghalu, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2200 W 21st St, Clovis, NM 88101 Phone: 575-769-7577 | |
Dr. Thien Tien Luu, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2000 W 21st St, #e-2, Clovis, NM 88101 Phone: 575-762-3726 Fax: 575-762-3727 | |
Kathryn E Winters, MD Pediatrics Medicare: Medicare Enrolled Practice Location: Plains Regional Medical Group, 2200 W 21st St, Clovis, NM 88101 Phone: 575-769-7577 Fax: 575-769-7595 |