DR. CLYDE WHITLEY VICK MD NPI 1003976648

NPI Information

NPI: 1003976648
Provider Name: DR. CLYDE WHITLEY VICK, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
1833 BOULEVARD
JACKSONVILLE, FL
ZIP 32206
Phone: (904) 232-2751
Get Directions

DR. Clyde Whitley Vick, MD is a diagnostic radiology radiology in Jacksonville, FL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Clyde Whitley Vick, MD NPI is 1003976648. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1833 BOULEVARD
JACKSONVILLE, FL
ZIP 32206-382
Phone: (904) 232-2751
Fax: (904) 232-2482

The NPI 1003976648 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/12/2006 and was last updated on 3/13/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085B0100X	Radiology	Body Imaging	028094	GEORGIA	No
2	2085N0700X	Radiology	Neuroradiology	028094	GEORGIA	No
3	2085N0904X	Radiology	Nuclear Radiology	028094	GEORGIA	No
4	2085P0229X	Radiology	Pediatric Radiology	028094	GEORGIA	No
5	2085R0204X	Radiology	Vascular & Interventional Radiology	028094	GEORGIA	No
6	2085U0001X	Radiology	Diagnostic Ultrasound	028094	GEORGIA	No
7	2085R0202X	Radiology	Diagnostic Radiology	028094	GEORGIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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