Individual
DR. MELINDA LEE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1453
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08145302
—
CO
01
—
410046449
METRA-HEALTH RR MDCR
CO
01
—
4285550001
DMERC
CO
Enumeration date
11/14/2006
Last updated
02/11/2021
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