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Individual

DR. JOHN B HICKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1213 56TH ST, MERIDIAN, MS 39305-1447
(601) 483-7812
(601) 482-4269
Mailing address
1213 56TH ST, MERIDIAN, MS 39305-1447
(601) 483-7812
(601) 482-4269

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
09618
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00123663
MS
Enumeration date
06/01/2005
Last updated
08/05/2008
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