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Individual

WILLIAM BRADLEY PICKERING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGACNP

Contact information

Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 264-6000
(601) 579-5212
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 264-6000
(601) 579-5240

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R802367
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09220725
MS
Enumeration date
05/24/2015
Last updated
02/28/2017
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