Individual
DR. JOHN R. HICKS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5046 HIGHWAY 17 BYP S, SUITE 100, MYRTLE BEACH, SC 29588-4503
(843) 293-5100
(843) 293-5101
Mailing address
5046 HIGHWAY 17 BYP S, SUITE 100, MYRTLE BEACH, SC 29588-4503
(843) 293-5100
(843) 293-5101
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
14089
SC
207RC0000X
Cardiovascular Disease Physician
Primary
14089
SC
207RC0001X
Clinical Cardiac Electrophysiology Physician
14089
SC
207RI0011X
Interventional Cardiology Physician
14089
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140895
—
SC
05
—
GP0749
—
SC
Enumeration date
05/10/2006
Last updated
06/27/2014
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