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Individual

DR. JENNIFER O HICKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
276 NISSAN PKWY, BUILDING E SUITE 100, CANTON, MS 39046-7006
(601) 855-4880
(601) 859-2995
Mailing address
276 NISSAN PKWY, BUILDING E SUITE 100, CANTON, MS 39046-7006
(601) 855-4880
(601) 859-2995

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
09855
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00114331
MS
01
D00992
UPIN
MS
Enumeration date
03/31/2006
Last updated
09/17/2013
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