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General NPI Number Information
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NPI Number | 1164775292
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Entity Type | Organization
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Legal Business Name | PIKAART ENTERPRISES, INC
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Dates
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Enumeration Date | 10/26/2012
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Last Update Date | 10/26/2012
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Provider Practice Location Address
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Address Line | 15954 JACKSON CREEK PKWY SUITE B, #436
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City | MONUMENT
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State | CO
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Zip | 80132-8532
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Country | US
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Telephone | 719-322-2253
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Fax |
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Provider Business Mailing Address
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Address Line | 15954 JACKSON CREEK PKWY SUITE B, #436
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City | MONUMENT
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State | CO
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Zip | 80132-8532
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Country | US
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Telephone | 719-322-2253
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DIRK PIKAART
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Credential | DO
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Telephone | 719-322-2253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 46622
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License Number State | CO
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