Healthcare Provider Details

I. General information

NPI: 1003952060
Provider Name (Legal Business Name): PATRICIA DIANE PILKINTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 12/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 LOOP ROAD EAST TUSCALOOSA VA MEDICAL CENTER
TUSCALOOSA AL
35404
US

IV. Provider business mailing address

3701 LOOP ROAD EAST TUSCALOOSA VA MEDICAL CENTER
TUSCALOOSA AL
35404
US

V. Phone/Fax

Practice location:
  • Phone: 205-554-2822
  • Fax: 205-554-2894
Mailing address:
  • Phone: 205-554-2822
  • Fax: 205-554-2894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25367
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: