Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Douglas Earl Vickstrom, MD

Individual provider Internal Medicine Physician · NPI 1063529105

Douglas Earl Vickstrom, MD is an Internal Medicine Physician in Bettendorf, Iowa. Licensed in Iowa. Registered with an NPI since 2006.

Licensed in
IA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2979 Victoria St VA Opt Clinic
Bettendorf, IA 52722
Phone: (563) 332-8528
Fax: (563) 332-9331
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 19440 (IA)

Record details

NPI number1063529105
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 24, 2006
Last updated in NPPESJuly 8, 2007

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