Healthcare Provider Details

I. General information

NPI: 1740544923
Provider Name (Legal Business Name): PATRICK BRANDON VICKERS D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6951 SW STATE ROAD 200
OCALA FL
34476-9210
US

IV. Provider business mailing address

6951 SW STATE ROAD 200
OCALA FL
34476-9210
US

V. Phone/Fax

Practice location:
  • Phone: 352-236-6806
  • Fax: 352-622-2033
Mailing address:
  • Phone: 352-236-6806
  • Fax: 352-622-2033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number34C.000742
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number0102203852
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number291512
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberOS017570
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number66645
License Number StateCT
# 6
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number01919
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number5101025796
License Number StateMI
# 8
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number2828
License Number StateTN
# 9
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberOS15017
License Number StateFL
# 10
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberDO.2401
License Number StateAL
# 11
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number25MB10490600
License Number StateNJ
# 12
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberDO231470
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: