Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 18186 | AL |
Y | 208600000X | Surgeon | 18186 | AL |
N | 208200000X | Surgeon | 49253 | MN |
N | 208600000X | Surgeon | 49253 | MN |
N | 2086X0206X | Surgical Oncologist | 18186 | AL |
NPI | 1215964754 |
---|---|
Provider Name | Dr. Selwyn Maurice Vickers |
First Address | Birmingham, AL 35294 |
Second Address | Birmingham, AL 35294-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 12/12/2013 |