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Individual

MICHAEL HICKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AA

Contact information

Practice address
2771 ASHLEIGH LN, ALPHARETTA, GA 30004-6169
(678) 867-6753
Mailing address
2771 ASHLEIGH LN, ALPHARETTA, GA 30004-6169
(678) 867-6753

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
004432
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
256304030A
GA
Enumeration date
01/05/2007
Last updated
05/21/2008
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