Individual
MR. ROBERT HICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3109 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-4361
(228) 818-1111
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R529613
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RDH00016433
—
MS
Enumeration date
02/23/2007
Last updated
07/08/2007
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