Individual
CASEY L PICKERILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 SOUTH ST, LAFAYETTE, IN 47904-3028
(765) 807-2320
(765) 807-2330
Mailing address
2525 SOUTH ST, LAFAYETTE, IN 47904-3028
(765) 807-2325
(765) 838-8264
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01046327
IN
207Q00000X
Family Medicine Physician
Primary
01046327A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000337599
ANTHEM PROVIDER NUMBER
IN
05
—
200133970A
—
IN
Enumeration date
03/16/2006
Last updated
01/10/2025
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