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NPI Code Detail

MEDICARE: DR. N EARLE PICKENS MD

MEDICARE: DR. N EARLE PICKENS MD
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
1208600000XSurgery PhysicianME0016345FL

General Provider Information

NPI Number : 1376541854
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. N EARLE PICKENS MD
Provider Business Mailing Address
First Line : 1143 NW 64TH TER
Second Line :
City : GAINESVILLE
State : FL
Zip : 32605-4218
Country : US
Telephone Number : 352-332-9611
Fax Number : 352-331-5273
Provider Business Practice Location Address
First Line : 1143 NW 64TH TER
Second Line :
City : GAINESVILLE
State : FL
Zip : 32605-4218
Country : US
Telephone Number : 352-332-9611
Fax Number : 352-331-5273
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 07/08/2007

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Directions to “ DR. N EARLE PICKENS MD” Practice Location

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