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Individual

DR. HORACE O. HICKMAN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., J.D.

Contact information

Practice address
5330 E STOP 11 RD, INDIANAPOLIS, IN 46237-6345
(317) 893-1900
(317) 893-1869
Mailing address
PO BOX 664056, INDIANAPOLIS, IN 46266-4056

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01023443A
IN
207RI0011X
Interventional Cardiology Physician
01023443A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060034936
MEDICARE RAILROAD
IN
05
100324010A
IN
Enumeration date
02/01/2006
Last updated
09/27/2016
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