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Organization

FAMILY MEDICINE CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WILLIAM EARL HICKS M.D. (PARTNER)
(712) 754-3658
Entity
Organization

Contact information

Practice address
600 9TH AVE N, SIBLEY, IA 51249-1012
(712) 754-3658
(712) 754-2634
Mailing address
600 9TH AVE N, PO BOX 277, SIBLEY, IA 51249-1012
(712) 754-3658
(712) 754-2634

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02096
IA
207Q00000X
Family Medicine Physician
02364
IA
207Q00000X
Family Medicine Physician
Primary
18374
IA
207Q00000X
Family Medicine Physician
18381
IA
207Q00000X
Family Medicine Physician
3511
IA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
18374
IA
207QS0010X
Sports Medicine (Family Medicine) Physician
18374
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0087106
IA
01
115341
MINNESOTA UCARE
MN
05
626810200
MN
Enumeration date
07/11/2005
Last updated
07/23/2009
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