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Individual

DR. CARLTON T HICKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
312 REDFERN VILLAGE, ST SIMONS ISLAND, GA 31522-1631
(912) 638-8652
(912) 638-0490
Mailing address
312 REDFERN VILLAGE, ST SIMONS ISLAND, GA 31522-1631
(912) 638-8652
(912) 638-0490

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT000651
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000068307A
GA
Enumeration date
07/20/2006
Last updated
05/03/2011
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