Individual
TODD L HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
580 LINCOLN PARK BLVD, STE 300, DAYTON, OH 45429-3474
(937) 396-8001
(937) 396-8003
Mailing address
2300 MIAMI VALLEY DR, STE 380, CENTERVILLE, OH 45459-1294
(937) 396-8001
(937) 396-8003
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35-08-5868
OH
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
35.085868
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2665174
—
OH
Enumeration date
08/01/2006
Last updated
10/04/2019
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