Pickett, Charlton Judson
Pickett, Charlton Judson is an individual health care provider with primary practice located at 1417 Pendleton Road , Augusta GA 30904-4837. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Pickett, Charlton Judson can be contacted via phone (706) 738-9824.Contact Information
Primary practice address
1417 Pendleton Road
Augusta GA 30904-4837
Phone: (706) 738-9824
Fax: (706) 736-4111
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 030528 | Georgia |
Profile Details
| NPI number | 1366429854 |
|---|---|
| LBN Legal business name | Pickett, Charlton Judson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 27th, 2005 |
| Last updated | Sep 21st, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366429854 | NPPES |
| Georgia | MEDICAID | 00377979B | |
| Georgia | MEDICAID | 140437 |
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