Individual
CAROL J HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
141 N KEYSER AVE, DESHLER, OH 43516-1111
(419) 278-2065
(419) 278-6500
Mailing address
745 HASKINS RD, SUITE B, BOWLING GREEN, OH 43402-1600
(419) 353-7069
(419) 353-7076
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.053028
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0620699
—
OH
Enumeration date
07/12/2006
Last updated
05/10/2016
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