Organization
FAMILY PRACTICE ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY PICKETT MD (OWNER)
(618) 939-3939
Entity
Organization
Contact information
Practice address
509 HAMACHER ST, SUITE 102, WATERLOO, IL 62298-1592
(618) 939-3939
(618) 939-3941
Mailing address
509 HAMACHER ST, SUITE 102, WATERLOO, IL 62298-1592
(618) 939-3939
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036081291
IL
Other
Enumeration date
09/17/2007
Last updated
10/29/2008
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