Healthcare Provider Details

I. General information

NPI: 1114660701
Provider Name (Legal Business Name): VICKIE M. SIZEMORE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2022
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 E DUBLIN GRANVILLE RD STE 150
COLUMBUS OH
43081-7023
US

IV. Provider business mailing address

PO BOX 7527
DUBLIN OH
43017-0727
US

V. Phone/Fax

Practice location:
  • Phone: 614-788-8650
  • Fax: 614-788-8651
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.018581
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number34.018581
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: