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Individual

DR. JOSHUA AARON HICKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3185 W STATE ST, SUITE 2010, BRISTOL, TN 37620-1600
(423) 968-7555
(423) 968-7641
Mailing address
3185 W STATE ST, SUITE 2010, BRISTOL, TN 37620-1600
(423) 968-7555
(423) 968-7641

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
0101251158
VA
207W00000X
Ophthalmology Physician
Primary
48289
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103I185426
TN
05
1851545677
VA
01
P010884191
RR MEDICARE
TN
Enumeration date
11/06/2008
Last updated
03/03/2015
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