Individual
GRANT WARREN HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 880-5385
(317) 880-0488
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
02006268A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001666570
ANTHEM PTAN
IN
05
—
300014764
—
IN
Enumeration date
03/29/2018
Last updated
12/05/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us