Individual
DR. THOMAS RYAN HICKERNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
260 LONG RIDGE ROAD, STAMFORD, CT 06927-3720
(203) 785-2579
Mailing address
260 LONG RIDGE RD, STAMFORD, CT 06902-1638
(203) 785-2579
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
72658
CT
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
72658
CT
Other
Enumeration date
04/11/2013
Last updated
10/19/2022
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