MEDICARE: WILLIAM S 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
1	207RI0011X	Interventional Cardiology Physician	ME23808	FL
2	207RC0000X	Cardiovascular Disease Physician	ME7968	AL
3	207RC0000X	Cardiovascular Disease Physician	ME23808	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669472940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM S PICKENS MD

Provider Business Mailing Address
First Line	:	1717 NORTH E STREET
Second Line	:	SUITE 333
City	:	PENSACOLA
State	:	FL
Zip	:	32501
Country	:	US
Telephone Number	:	850-444-1717
Fax Number	:	850-857-1747

Provider Business Practice Location Address
First Line	:	1717 N E ST
Second Line	:	SUITE 331
City	:	PENSACOLA
State	:	FL
Zip	:	32501-6339
Country	:	US
Telephone Number	:	850-444-1717
Fax Number	:	850-857-1747

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	06/26/2014

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Directions to “ WILLIAM S PICKENS MD” Practice Location

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