MEDICARE: DR. DAVID E. PICKERING PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	P-1223	TN

General Provider Information

NPI Number	:	1578569604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID E. PICKERING PH.D.

Provider Business Mailing Address
First Line	:	78 CHIP OAK DR
Second Line	:
City	:	MEDON
State	:	TN
Zip	:	38356-8128
Country	:	US
Telephone Number	:	731-668-2277
Fax Number	:	731-660-0510

Provider Business Practice Location Address
First Line	:	367B N PARKWAY
Second Line	:	STE 1
City	:	JACKSON
State	:	TN
Zip	:	38305-2899
Country	:	US
Telephone Number	:	731-668-2277
Fax Number	:	731-660-0510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	06/08/2026

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