# EDGAR HICKS, MD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hicks Orthopedic Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487748539
- **Authorized official:** DR. EDGAR O HICKS M.D. (PRESIDENT/OWNER)
- **Authorized official phone:** (715) 834-2701

## Contact information

- **Practice address:** 836 RICHARD DR, EAU CLAIRE, WI 54701-6242
- **Practice address phone:** (715) 834-2701
- **Practice address fax:** (715) 834-2972
- **Mailing address:** 836 RICHARD DR, EAU CLAIRE, WI 54701-6242
- **Mailing address phone:** (715) 834-2701
- **Mailing address fax:** (715) 834-2972

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 21719-020 | WI | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 06/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 30187000 | — | WI |