Organization
HIGH DESERT FAMILY MEDICINE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD B HICKS II MD (OWNER)
(775) 352-3520
Entity
Organization
Contact information
Practice address
2345 E PRATER WAY, STE. 301, SPARKS, NV 89434-9600
(775) 352-3520
(775) 352-3523
Mailing address
2345 E PRATER WAY, STE. 301, SPARKS, NV 89434-9600
(775) 352-3520
(775) 352-3523
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7996
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235369646
MEDICAID GROUP
NV
05
—
1326044520
—
NV
Enumeration date
07/20/2009
Last updated
07/27/2017
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