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Individual

MR. JOHN ROGER HICKMAN III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
199 12TH STREET EXT, PRINCETON, WV 24740-2352
(304) 425-2188
(304) 425-2189
Mailing address
199 12TH STREET EXT, PRINCETON, WV 24740-2352
(304) 425-2188
(304) 425-2189

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5286
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NABP
50033778
WV
Enumeration date
09/30/2006
Last updated
07/08/2007
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