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Individual

JOHN ERIC BICKNELL SR.

Active
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Individual

JOHN ERIC BICKNELL SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
016810
LA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
016810
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1392715
LA
05
X9X029868
TX
Enumeration date
11/29/2006
Last updated
11/13/2012
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