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Individual

LINDSAY HICKERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1350 HICKORY ST, MELBOURNE, FL 32901
(321) 434-1401
(321) 434-1667
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1981
(321) 951-7408

Taxonomy

Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
273286
NY
207XX0801X
Orthopaedic Trauma Physician
31400
OK
207XX0801X
Orthopaedic Trauma Physician
Primary
ME140535
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102741400
FL
01
LD519
MEDICARE
FL
01
LD522
MEDICARE
FL
Enumeration date
06/15/2009
Last updated
08/13/2019
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