MEDICARE: DR. JOHN M BICKERTON D.O.

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
1	152W00000X	Optometrist	0618000811	VA

General Provider Information

NPI Number	:	1376677666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN M BICKERTON D.O.

Provider Business Mailing Address
First Line	:	8107 MIDLOTHIAN TPKE
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-5115
Country	:	US
Telephone Number	:	804-330-2588
Fax Number	:	804-330-4396

Provider Business Practice Location Address
First Line	:	8107 MIDLOTHIAN TPKE
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-5115
Country	:	US
Telephone Number	:	804-330-2588
Fax Number	:	804-330-4396

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	10/26/2017

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