Individual
THEODORE C HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1010 S REED RD, KOKOMO, IN 46901-6248
(765) 457-4370
Mailing address
746 N 1100 W, KEMPTON, IN 46049-9787
(317) 441-5347
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001034A
IN
Other
Enumeration date
10/06/2008
Last updated
07/21/2022
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