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NPI Code Detail

MEDICARE: DR. JOEL VANSICKLER M.D.

MEDICARE: DR. JOEL VANSICKLER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology PhysicianME54727FL
2174400000XSpecialistME 54727FL

General Provider Information

NPI Number : 1245281864
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOEL VANSICKLER M.D.
Provider Business Mailing Address
First Line : 7981 GLADIOLUS DR
Second Line :
City : FT MYERS
State : FL
Zip : 33908-4154
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7981 GLADIOLUS DR
Second Line :
City : FT MYERS
State : FL
Zip : 33908-4154
Country : US
Telephone Number : 239-939-0999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 08/25/2020

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