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General NPI Number Information
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NPI Number | 1265346670
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Entity Type | Organization
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Legal Business Name | VICKTREE INC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 4108 BLUE HOLLOW DR
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City | COLUMBIA
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State | MO
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Zip | 65203-7256
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Country | US
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Telephone | 216-299-2522
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Fax |
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Provider Business Mailing Address
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Address Line | 500 MARKET ST
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City | FULTON
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State | MO
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Zip | 65251-2808
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Country | US
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Telephone | 573-219-0858
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. GAURAV KULKARNI
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Credential | MD
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Telephone | 513-219-0858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | NULL
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