Individual
KENNETH HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 KERMIT DR, STE 106, NASHVILLE, TN 37217-2121
(615) 361-6953
(615) 360-0947
Mailing address
1100 KERMIT DR, STE 106, NASHVILLE, TN 37217-2121
(615) 361-6953
(615) 360-0947
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD0000011486
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3186178
—
TN
Enumeration date
01/20/2006
Last updated
10/11/2013
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