Individual
MR. DAVID EUGENE PICKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.PH.
Contact information
Practice address
205 S PARK LN STE 110, ALTUS, OK 73521-5733
(580) 482-6464
Mailing address
417 BUENA VISTA, ALTUS, OK 73521
(580) 482-0158
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7962
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7962
STATE LICENSE NUMBER
OK
Enumeration date
07/07/2006
Last updated
07/08/2007
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