Individual
JAIME WICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1364 CLIFTON RD NE STE BG20, ATLANTA, GA 30322-1001
(404) 712-4596
Mailing address
1320 S UNIVERSITY DR STE 500, FORT WORTH, TX 76107-5732
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
88295
GA
2085N0700X
Neuroradiology Physician
Primary
W4996
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/21/2015
Last updated
05/01/2026
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