Organization
AIA,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID BARTON HICKMAN CRNA (PRESIDENT)
(435) 553-9345
Entity
Organization
Contact information
Practice address
113 ADKINS CT, CLOVIS, NM 88101-9373
(435) 553-9345
(575) 356-8516
Mailing address
113 ADKINS CT, CLOVIS, NM 88101-9373
(435) 553-9345
(575) 356-8516
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
CRNA-01248
NM
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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