Organization
BRYAN HICKS MD PA
Active
Other names
Marion Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN CRAIG HICKS MD (PRESIDENT)
(352) 368-5858
Entity
Organization
Contact information
Practice address
5349 SW COLLEGE RD, STE 2, OCALA, FL 34474-5717
(352) 368-5858
(352) 368-2044
Mailing address
5349 SW COLLEGE RD, STE 2, OCALA, FL 34474-5717
(352) 368-5858
(352) 368-2044
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME47583
FL
207ND0101X
MOHS-Micrographic Surgery Physician
ME47583
FL
207ND0900X
Dermatopathology Physician
ME47583
FL
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
ME47583
FL
207NS0135X
Procedural Dermatology Physician
ME47583
FL
Other
Enumeration date
09/20/2006
Last updated
04/15/2008
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