Individual
DR. KENNETH S HICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5801 BREMO RD, ST FRANCIS EMERGENCY DEPARTMENT, RICHMOND, VA 23226-1907
(804) 287-7066
(804) 673-9531
Mailing address
2223 PARKERS HILL DR, MAIDENS, VA 23102-2244
(804) 556-5170
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101233603
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114228
BLUE SHILED
VA
01
—
114708
BLUE SHIELD
VA
05
—
1356343941
—
VA
01
—
204990
BLUE SHIELD
VA
01
—
232562
BLUE SHIELD
VA
01
—
234124
BLUE SHIELD
VA
Enumeration date
08/12/2005
Last updated
04/01/2024
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