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NPI Code Detail

MEDICARE: DR. JASON CODY PICKETT M.D.

MEDICARE: DR. JASON CODY PICKETT M.D.
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
1207P00000XEmergency Medicine Physician25116MS

Other Identifiers

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

General Provider Information

NPI Number : 1699138479
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON CODY PICKETT M.D.
Provider Business Mailing Address
First Line : 362 S THOMAS ST
Second Line :
City : TUPELO
State : MS
Zip : 38801-5333
Country : US
Telephone Number : 662-223-3737
Fax Number : 601-429-9294
Provider Business Practice Location Address
First Line : 830 S GLOSTER ST
Second Line :
City : TUPELO
State : MS
Zip : 38801-4996
Country : US
Telephone Number : 662-377-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2016
Last Update Date : 05/10/2024

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