DOUGLAS EARL VICKSTROM MD
NPI 1063529105
Internal Medicine in Bettendorf, IA

Active since August 24, 2006
2979 VICTORIA ST, VA OPT CLINIC, BETTENDORF, IA 52722(563) 332-8528(563) 332-9331 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Douglas Earl Vickstrom Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOUGLAS EARL VICKSTROM MD (NPI 1063529105) is an individual internal medicine provider in Bettendorf, Iowa, licensed in Iowa (19440) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1063529105
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDOUGLAS EARL VICKSTROMCredential: MD
Location Address2979 VICTORIA ST, VA OPT CLINICBettendorf, IA 52722
Mailing Address25665 Valley DriveBettendorf, IA 52722-7315 · (563) 332-4172 · Fax (563) 332-4172
Fax(563) 332-9331
Sole ProprietorNo
Enumeration DateAugust 24, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1063529105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in IA · 19440
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

2979 VICTORIA ST, Bettendorf, IA 52722

Other Identifiers 1

Medicare UPINA01279

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Psychiatric/Mental Health)
2979 VICTORIA ST
BETTENDORF, IA 52722
Internal Medicine
2979 VICTORIA ST
BETTENDORF, IA 52722
Family Medicine
2979 VICTORIA ST
BETTENDORF, IA 52722
Nurse Practitioner (Gerontology)
2979 VICTORIA ST
BETTENDORF, IA 52722
Registered Nurse (Psychiatric/Mental Health, Adult)
2979 VICTORIA ST
BETTENDORF, IA 52722
Internal Medicine
2979 VICTORIA ST, VA CLINIC
BETTENDORF, IA 52722
Social Worker (Clinical)
2979 VICTORIA ST
BETTENDORF, IA 52722
Clinic/Center
2979 VICTORIA ST
BETTENDORF, IA 52722

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1063529105, enumerated as an "individual" on August 24, 2006.

The provider is located at 2979 VICTORIA ST VA OPT CLINIC BETTENDORF, IA 52722 and the phone number is (563) 332-8528.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.