Individual
LEONARD RAY HICKMAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
22530 US HIGHWAY 98, FAIRHOPE, AL 36532-8303
(251) 929-7359
(251) 929-7364
Mailing address
22530 US HIGHWAY 98, FAIRHOPE, AL 36532-8303
(251) 929-7359
(251) 929-7364
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11113
AL
183500000X
Pharmacist
25836
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11113
STATE LICENSE
AL
01
—
25836
STATE LICENSE
FL
Enumeration date
01/18/2013
Last updated
01/18/2013
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