Individual
TIMOTHY D BICKNELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 NORTH ST, VERGENNES, VT 05491-1107
(802) 877-3466
(802) 877-1188
Mailing address
104 PORTER DR, MIDDLEBURY, VT 05753-8527
(802) 388-8808
(802) 388-8322
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042 0009191
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OVN1240
—
VT
Enumeration date
10/18/2005
Last updated
07/08/2007
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