Organization
STEPHEN A. HICKNER, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN ANDREW HICKNER M.D. (REGISTERED AGENT)
(616) 633-8628
Entity
Organization
Contact information
Practice address
8160 HIGHWAY 789, LANDER, WY 82520-2953
(616) 633-8628
Mailing address
8160 HIGHWAY 789, LANDER, WY 82520-2953
(616) 633-8628
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
TL1524
WY
Other
Enumeration date
03/22/2011
Last updated
03/29/2011
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