Individual
DR. EDSON CONRAD HICKS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4221 E CHANDLER BLVD STE 119, PHOENIX, AZ 85048-8878
(480) 223-1901
(480) 393-6930
Mailing address
PO BOX 12293, CASA GRANDE, AZ 85230-2293
(480) 223-1901
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
29616
AZ
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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