Individual
ROBERT G PICKERILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1086 FRANKLIN ST, JOHNSTOWN, PA 15905-4305
(814) 242-0520
Mailing address
1107 CLUB DR, JOHNSTOWN, PA 15905-1906
(814) 242-0520
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD019294E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009133850004
—
PA
01
—
1025205
GATEWAY
PA
01
—
547286
HIGHMARK BLUE SHIELD
PA
01
—
87201
THREE RIVERS HEALTH PLAN
PA
01
—
P31109403853
ION HEALTH
PA
Enumeration date
09/06/2005
Last updated
03/08/2016
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