Individual
GARY R BICKFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, FNP-BC
Contact information
Practice address
110 PERIMETER PARK RD, SUITE G, KNOXVILLE, TN 37922-2200
(865) 247-6340
(865) 241-5966
Mailing address
110 PERIMETER PARK RD, SUITE G, KNOXVILLE, TN 37922-2200
(865) 247-6340
(865) 241-5966
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN0000012264
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APN0000012264
STATE LICENSE
TN
Enumeration date
01/31/2007
Last updated
07/15/2011
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