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Individual
DR. DAVID C HICKS
Active
Individual
DR. DAVID C HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
2004009696
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2004009696
STATE LICENSE
MO
05
—
209273309
—
MO
Enumeration date
11/09/2005
Last updated
08/31/2012
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