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Individual

JEFFREY A HICKLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2310
Mailing address
8000 W 110TH ST, STE 150, OVERLAND PARK, KS 66210-2338
(913) 599-6777
(913) 599-3955

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
04-27554
KS
2085R0202X
Diagnostic Radiology Physician
4257-320
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100312920C
KS
05
203938212 - SMMC
MO
01
24884043
BCBS
KS
Enumeration date
08/20/2006
Last updated
07/31/2025
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