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NPI Code Detail

MEDICARE: TIMOTHY A PICKETT JR.

MEDICARE:   TIMOTHY A PICKETT JR.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry11802NC

General Provider Information

NPI Number : 1144846627
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY A PICKETT JR.
Provider Business Mailing Address
First Line : 1915 W PARK DR STE 104
Second Line :
City : NORTH WILKESBORO
State : NC
Zip : 28659-3777
Country : US
Telephone Number : 336-667-5170
Fax Number : 336-903-7310
Provider Business Practice Location Address
First Line : 1135 N CHURCH ST
Second Line :
City : BURLINGTON
State : NC
Zip : 27217-2701
Country : US
Telephone Number : 336-395-1627
Fax Number : 336-450-1810
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2020
Last Update Date : 05/05/2026

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Directions to “ TIMOTHY A PICKETT JR. ” Practice Location

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