Provider Demographics
NPI:1265480867
Name:BICKEL, STEVEN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:BICKEL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:127 N OAK AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2435
Mailing Address - Country:US
Mailing Address - Phone:931-783-5857
Mailing Address - Fax:931-526-6760
Practice Address - Street 1:228 W 4TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2488
Practice Address - Country:US
Practice Address - Phone:931-372-0401
Practice Address - Fax:931-783-4269
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN2235363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S17154Medicare UPIN