CASEY VICKSTROM MD, PHD
NPI 1154053411
Psychiatry & Neurology - Neurology in Saint Louis, MO

Q: What is the provider's specialty?

The provider's specialty is Psychiatry & Neurology with taxonomy code 2084N0400X and a focus in Neurology.

Active since June 27, 2022

1 CHILDRENS PL STE 3S34, SAINT LOUIS, MO 63110(314) 454-6006 Get Directions Write a Review

NPPES record last updated: July 16, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Casey Vickstrom Md, Phd NPPES

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

CASEY VICKSTROM MD, PHD (NPI 1154053411) is an individual neurology provider in Saint Louis, Missouri, licensed in Missouri (2023040873) and active in the NPI registry since June 2022.

NPPES Registry Identity

NPI1154053411

Entity TypeIndividualMale

Primary Taxonomy2084N0400X

Provider Legal NameCASEY VICKSTROMCredential: MD, PHD

Location Address1 CHILDRENS PL STE 3S34Saint Louis, MO 63110-1002

Mailing Address1 Childrens Pl Ste 3s34Saint Louis, MO 63110-1002 · (314) 454-6120 · Fax (314) 454-4225

Phone(314) 454-6006

Sole ProprietorNo

Enumeration DateJune 27, 2022

Last NPPES UpdateJuly 16, 2024

NPPES CertifiedJuly 16, 2024

✔ NPI 1154053411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians

Taxonomy Code2084N0400X

License✔ Licensed in MO · 2023040873

Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

1 CHILDRENS PL STE 3S34, Saint Louis, MO 63110

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