Individual
TRAVIS PICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5211 EASON ST, SOUTHPORT, NC 28461-6901
(910) 454-0563
(910) 454-0567
Mailing address
1729 NEW HANOVER MEDICAL PARK DR, WILMINGTON, NC 28403-5345
(910) 763-3601
(910) 763-4608
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2098
NC
Other
Enumeration date
07/11/2006
Last updated
10/27/2020
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