# FAMILY MEDICINE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124026489
- **Authorized official:** DR. WILLIAM EARL HICKS M.D. (PARTNER)
- **Authorized official phone:** (712) 754-3658

## Contact information

- **Practice address:** 600 9TH AVE N, SIBLEY, IA 51249-1012
- **Practice address phone:** (712) 754-3658
- **Practice address fax:** (712) 754-2634
- **Mailing address:** 600 9TH AVE N, PO BOX 277, SIBLEY, IA 51249-1012
- **Mailing address phone:** (712) 754-3658
- **Mailing address fax:** (712) 754-2634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 02096 | IA | — |
| 207Q00000X | Family Medicine Physician | 02364 | IA | — |
| 207Q00000X | Family Medicine Physician | 18374 | IA | Yes |
| 207Q00000X | Family Medicine Physician | 18381 | IA | — |
| 207Q00000X | Family Medicine Physician | 3511 | IA | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | 18374 | IA | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | 18374 | IA | — |

## Other

- **Enumeration date:** 07/11/2005
- **Last updated:** 07/23/2009