Healthcare Provider Details

I. General information

NPI: 1568572675
Provider Name (Legal Business Name): SUSAN N PICK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

493 LANTANA RD
CROSSVILLE TN
38555
US

IV. Provider business mailing address

PO BOX 568
CROSSVILLE TN
38557-0568
US

V. Phone/Fax

Practice location:
  • Phone: 931-707-8383
  • Fax: 931-707-1076
Mailing address:
  • Phone: 931-707-8383
  • Fax: 931-707-1076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number023765
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number023765
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: