Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 1844 | AL |
N | 207Q00000X | Family Doctor | 36666 | SC |
N | 207Q00000X | Family Doctor | LL36666 | SC |
N | 207VX0000X | Obstetrician | 1844 | AL |
NPI | 1003229774 |
---|---|
Provider Name | Brittney Renee Bicksler |
First Address | Bay Minette, AL 36507-4163 |
Second Address | Bay Minette, AL 36507-4163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2014 |
Last Update Date | 07/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
366669 | (05) | SC |
SC80723365 | MEDICARE PIN (01) | SC |
SC80726067 | MEDICARE PIN (01) | SC |
SC80726121 | MEDICARE PIN (01) | SC |