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General NPI Number Information
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NPI Number | 1003128893
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Entity Type | Individual
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Provider Name | KIMBERLY LYNN PICKETT M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/08/2010
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 2051 HAMILL RD STE 210
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City | HIXSON
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State | TN
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Zip | 37343-4653
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Country | US
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Telephone | 423-870-1999
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 80426
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City | CHATTANOOGA
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State | TN
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Zip | 37414-7426
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD0000050418
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License Number State | TN
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