Individual
FRED WAYNE HICKS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
208 MEDICAL PARK BLVD, BRISTOL, TN 37620-7343
(423) 989-4050
(423) 990-3044
Mailing address
208 MEDICAL PARK BLVD, BRISTOL, TN 37620-7343
(423) 989-4050
(423) 990-3044
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
74888
FL
Other
Enumeration date
03/23/2022
Last updated
08/04/2025
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