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Individual

JAMES R HICKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
36157
MN
2083P0901X
Public Health & General Preventive Medicine Physician
36157
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110002365
RAILROAD MEDICARE
MN
05
32646400
WI
05
888527300
MN
05
ENROLLED
IA
Enumeration date
02/15/2006
Last updated
02/10/2012
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