Individual
DR. ANNELIES HICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 412-6594
Mailing address
3551 ROGER BROOKE DRIVE, MCHE/ME, JBSA FORT SAM HOUSTON, TX 78234
(210) 916-6554
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101262158
VA
208600000X
Surgery Physician
5771767
ID
Other
Enumeration date
02/16/2015
Last updated
08/21/2025
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