Provider Demographics
NPI:1891372199
Name:VICKERS, ROBERT FAVROT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FAVROT
Last Name:VICKERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2451 UNIVERSITY HOSPITAL DR RM 714
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36617-2300
Mailing Address - Country:US
Mailing Address - Phone:251-434-3475
Mailing Address - Fax:251-434-3837
Practice Address - Street 1:2451 UNIVERSITY HOSPITAL DR RM 714
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2300
Practice Address - Country:US
Practice Address - Phone:251-434-3475
Practice Address - Fax:251-434-3837
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program