Individual
DR. PAUL SANFORD PICKHOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7557 DANNAHER DR, SUITE 130, POWELL, TN 37849-3558
(865) 859-7330
(865) 859-7339
Mailing address
7557 DANNAHER DR, SUITE 130, POWELL, TN 37849-3558
(865) 859-7330
(865) 859-7339
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD49699
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3810011422
MEDICAID
WV
01
—
P01203321
RR MEDICARE PTAN
WV
01
—
WV0682A
MEDICARE PTAN
WV
Enumeration date
08/21/2006
Last updated
04/21/2017
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