IndividualActive
Casey Vickstrom, MD, PHD
NPI 1154053411 · Neurology Physician · Saint Louis, MO
Provider details
- NPI number
- 1154053411
- Entity type
- Individual
- Primary specialty
- Neurology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD, PHD
- Sex
- Male
- Sole proprietor
- No
- License
- 2023040873 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1 Childrens Pl Ste 3s34
Saint Louis, MO 63110-1002
Phone: (314) 454-6006
Approximate (ZIP-level) locationGet directions
Mailing address
1 Childrens Pl Ste 3s34
Saint Louis, MO 63110-1002
Registry dates
- Enumerated
- 2022-06-27
- Last updated
- 2024-07-16
- Certified
- 2024-07-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.