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General NPI Number Information
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NPI Number | 1033636667
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Entity Type | Organization
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Legal Business Name | LESLIE M. PICKETT MD PLLC
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Dates
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Enumeration Date | 08/24/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1924 PINE ST STE 504
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City | ABILENE
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State | TX
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Zip | 79601-2452
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Country | US
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Telephone | 325-670-4730
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Fax | 325-670-4736
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Provider Business Mailing Address
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Address Line | 1924 PINE ST STE 504
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City | ABILENE
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State | TX
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Zip | 79601-2452
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Country | US
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Telephone | 325-670-4730
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Fax | 325-670-4736
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Authorized Official
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Title or Position | OWNER
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Name | LESLIE HUTCHINS
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Credential | MD
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Telephone | 325-670-4730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | Q3015
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License Number State | TX
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