Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 16929 | AL |
NPI | 1023019445 |
---|---|
Provider Name | Dr. Joel D Pickett |
First Address | Huntsville, AL 35804-2705 |
Second Address | Huntsville, AL 35801-4317 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 26/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000088423 | (05) | AL |
140003138 | MEDICARE RR (01) | |
F41495 | (02) |