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

Michael L Vick

Individual provider Otolaryngology Physician · NPI 1073503165

Michael L Vick is an Otolaryngology in Dallas, Georgia. Qualified in 1996, 30 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
30
Licensed in
GA
In the registry since
2005

Practice location Address checks out

504 W Memorial Dr
Dallas, GA 30132-4119
Phone: (770) 505-7190
Fax: (770) 793-7413
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X · Licence 044656 (GA)

Record details

NPI number1073503165
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 28, 2005
Last updated in NPPESJuly 8, 2007
Mailing address504 W Memorial Dr, Dallas, GA 30132-4119

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOTOLARYNGOLOGY
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Dallas