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General NPI Number Information
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NPI Number | 1952529091
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Entity Type | Organization
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Legal Business Name | ALEX PICKENS & ASSOC M D P C
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 09/16/2011
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Provider Practice Location Address
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Address Line | 15639 W MCNICHOLS RD
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City | DETROIT
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State | MI
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Zip | 48235-3541
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Country | US
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Telephone | 313-272-2400
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Fax | 313-535-9060
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Provider Business Mailing Address
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Address Line | PO BOX 23518
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City | DETROIT
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State | MI
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Zip | 48223-0518
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Country | US
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Telephone | 313-272-2400
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Fax | 313-535-9060
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ALEX PICKENS JR.
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Credential | M,D,
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Telephone | 313-272-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
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License Number | 4301038348
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License Number State | MI
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