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Individual
JAMES EDWARD HICKS
Active
Individual
JAMES EDWARD HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104557201
VA
111N00000X
Chiropractor
4710
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000204939
ANTHEM BLUE CROSS BLUE SH
OH
05
—
0261103
—
OH
01
—
522226428
TAX I.D.
OH
01
—
52222642800
BWC NUMBER
OH
01
—
522226428027
CARESOURCE
OH
Enumeration date
12/21/2006
Last updated
09/29/2022
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