CASEY VICKSTROM MD PHD NPI 1154053411

NPI Information

  • NPI: 1154053411
  • Provider Name: CASEY VICKSTROM, MD, PHD
  • Classification: Psychiatry & Neurology - 2084N0400X
  • Specialization: Neurology
  • Entity Type: Individual
  • Address: 1 CHILDRENS PL STE 3S34
    SAINT LOUIS, MO
    ZIP 63110
  • Phone: (314) 454-6006

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NPI Details

Casey Vickstrom, MD, PHD is a neurology psychiatry neurology in Saint Louis, MO. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. Casey Vickstrom, MD, PHD NPI is 1154053411. 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:

1 CHILDRENS PL STE 3S34
SAINT LOUIS, MO
ZIP 63110-002
Phone: (314) 454-6006

The enumeration date for this NPI number is 6/27/2022 and was last updated on 7/16/2024.

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
12084N0400XPsychiatry & NeurologyNeurology2023040873MISSOURIYes

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: 11/21/2025

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