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Organization
WINNIE CLAIRE HICKS
Active
Organization
WINNIE CLAIRE HICKS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WINNIE CLAIRE HICKS M.D. (MEDICAL DOCTOR)
(912) 588-2511
Entity
Organization
Contact information
Practice address
162 MEMORIAL DR, JESUP, GA 31545-0101
(912) 588-2511
(912) 588-2518
Mailing address
162 MEMORIAL DR, JESUP, GA 31545-0101
(912) 588-2511
(912) 588-2518
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
029466
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000369597A
—
GA
01
—
238379
BLUE CROSS/BLUE SHIELD
GA
01
—
252867447
INSURANCES
GA
01
—
GRP2943
MEDICARE GROUP #
GA
Enumeration date
07/08/2008
Last updated
07/08/2008
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