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General NPI Number Information
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NPI Number | 1720472053
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Entity Type | Individual
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Provider Name | JONATHAN ERNEST PICKETT M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/25/2015
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | U.S. ARMY HEALTH CLINIC STUTTGART UNIT 30401, PATCH BARRACKS, GERMANY
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City | APO
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State | AE
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Zip | 09154
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Country | US
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Telephone | 253-968-2825
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Fax |
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Provider Business Mailing Address
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Address Line | CMR 480 BOX 1729
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City | APO
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State | AE
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Zip | 09128
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Country | US
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Telephone | 496-371-9464
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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 | 29434
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License Number State | NE
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