Individual
THOMAS GLENN HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 341-6417
(269) 341-8743
Mailing address
680 COLUMBIA AVE W, BATTLE CREEK, MI 49015-3028
(269) 965-4500
(269) 965-1150
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301035006
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C910950
BCBSM
MI
05
—
1700986965
—
MI
01
—
TH035006
BCBCN
MI
Enumeration date
09/25/2006
Last updated
03/27/2014
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