Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 39863 | NC |
NPI | 1003942483 |
---|---|
Provider Name | Dr. John Mark Picton |
First Address | Lenoir, NC 28645-4973 |
Second Address | Lenoir, NC 28645-4973 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 07/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E81198 | (02) | NC |