Individual
CLIFTON C HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
161 WADSWORTH DR, RICHMOND, VA 23236-4500
(804) 484-3702
(804) 320-6462
Mailing address
161 WADSWORTH DR, RICHMOND, VA 23236-4500
(804) 484-3702
(804) 320-6462
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101033277
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010171431
—
VA
Enumeration date
03/14/2006
Last updated
12/28/2010
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