Individual
DR. KIMBERLY GRIFFIN HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
460 MEDICAL PARK DR, SUITE 108, LENOIR CITY, TN 37772-5782
(865) 271-9536
(865) 986-0212
Mailing address
460 MEDICAL PARK DR, SUITE 108, LENOIR CITY, TN 37772-5782
(865) 271-9536
(865) 986-0212
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD34033
TN
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
MD34033
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1516025
—
TN
05
—
3496552
—
TN
01
—
4034474
BLUE CROSS
TN
05
—
64054729
—
KY
Enumeration date
06/29/2006
Last updated
12/03/2012
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