Provider Demographics
NPI:1568572675
Name:PICK, SUSAN N (MD)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:N
Last Name:PICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 568
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38557-0568
Mailing Address - Country:US
Mailing Address - Phone:931-707-8383
Mailing Address - Fax:931-707-1076
Practice Address - Street 1:493 LANTANA RD
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555
Practice Address - Country:US
Practice Address - Phone:931-707-8383
Practice Address - Fax:931-707-1076
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN023765207X00000X, 225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3060722OtherBCBS PROVIDER NUMBER
TN621586903OtherTRICARE PROVIDER NUMBER
TNTN9999OtherUNITED WORLD LIFE INS
1346420924OtherGROUP NPI
TN621586903OtherUNITED HEALTHCARE
TN6215869030001OtherCIGNA
TN165713900OtherDEPT OF LABOR
TN3279965OtherCIGNA
TN62158690338555A001OtherTRICARE
TN1196780001OtherCIGNA GOVT SERVICES DME
TN3716258Medicaid
TN3060722OtherTENNCARE SELECT
TN621586903OtherAETNA PROVIDER NUMBER
TN621586903OtherAETNA PROVIDER NUMBER
TN62158690338555A001OtherTRICARE
TN3716258Medicaid