Individual
BRADLEY P. PICKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2745
(505) 272-8950
(505) 272-3202
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
(505) 272-3202
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
97-34
NM
207YX0901X
Otology & Neurotology Physician
Primary
97-341
NM
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
97-34
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
384941
—
AZ
05
—
Q2517
—
NM
Enumeration date
11/03/2006
Last updated
10/09/2024
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