Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | L3312.R | AL |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 83627 | GA |
NPI | 1659634830 |
---|---|
Provider Name | Meredith Lynne Pickett |
First Address | Atlanta, GA 30374-2616 |
Second Address | Gainesville, GA 30501-3715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2012 |
Last Update Date | 21/01/2021 |