Provider Demographics
NPI:1376677666
Name:BICKERTON, JOHN M (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:BICKERTON
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:8107 MIDLOTHIAN TPKE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-5115
Mailing Address - Country:US
Mailing Address - Phone:804-330-2588
Mailing Address - Fax:804-330-4396
Practice Address - Street 1:8107 MIDLOTHIAN TPKE
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5115
Practice Address - Country:US
Practice Address - Phone:804-330-2588
Practice Address - Fax:804-330-4396
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0618000811152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist