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General NPI Number Information
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NPI Number | 1245412477
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Entity Type | Organization
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Legal Business Name | HAROLD L. PICKENS, O.D.
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 08/27/2012
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Provider Practice Location Address
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Address Line | 90 N 4TH ST
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City | MARTINS FERRY
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State | OH
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Zip | 43935-1648
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Country | US
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Telephone | 740-633-2456
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Fax | 740-633-2334
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Provider Business Mailing Address
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Address Line | 90 N 4TH ST
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City | MARTINS FERRY
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State | OH
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Zip | 43935-1648
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Country | US
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Telephone | 740-633-2456
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Fax | 740-633-2334
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Authorized Official
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Title or Position | OWNER
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Name | DR. HAROLD L PICKENS
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Credential | O.D.
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Telephone | 740-633-2456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 3689 T792
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3689 T792
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License Number State | OH
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