Individual
DR. THOMAS DENNIS HICKEY
Active
Individual
DR. THOMAS DENNIS HICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
CHIA-473
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010147245
BLUE SHIELD
ID
01
—
C473-6
BLUE CROSS
ID
Enumeration date
11/02/2006
Last updated
07/09/2007
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