Individual
BRIAN J. HICKOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
980 W IRONWOOD DR, STE 302, COEUR D ALENE, ID 83814
(208) 292-5437
(208) 292-5437
Mailing address
980 W. IRONWOOD DRIVE, SUITE 302, COEUR D'ALENE, ID 83814-9998
(208) 292-5437
(208) 292-5441
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M9558
ID
Other
Enumeration date
06/17/2006
Last updated
09/05/2012
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