Individual
JACOB HARRY PICKLE IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3131 COLLEGE HEIGHTS BLVD, SUITE 1200, ALLENTOWN, PA 18104-4812
(610) 439-8551
(610) 439-1435
Mailing address
3131 COLLEGE HEIGHTS BLVD, SUITE 1200, ALLENTOWN, PA 18104-4812
(610) 439-8551
(610) 439-1435
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD03476SE
PA
207RG0100X
Gastroenterology Physician
Primary
MD03476SE
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011987300001
—
PA
Enumeration date
08/10/2005
Last updated
09/18/2015
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