Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 2902 | NC |
Y | 103TC0700X | Clinical Psychologist | 2902 | NC |
NPI | 1003885252 |
---|---|
Provider Name | Dr. David William Macvicar |
First Address | Tuscaloosa, AL 35404-5015 |
Second Address | Tuscaloosa, AL 35404-5015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 05/12/2012 |