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NPI Code Detail

MEDICARE: RONALD B. HICKS II MD

MEDICARE:   RONALD B. HICKS II MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician7996NV

General Provider Information

NPI Number : 1326044520
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONALD B. HICKS II MD
Provider Business Mailing Address
First Line : 2345 E PRATER WAY
Second Line : STE 301
City : SPARKS
State : NV
Zip : 89434-9639
Country : US
Telephone Number : 775-352-3520
Fax Number : 775-352-3523
Provider Business Practice Location Address
First Line : 5975 S LOS ALTOS PKWY
Second Line :
City : SPARKS
State : NV
Zip : 89436-7699
Country : US
Telephone Number : 775-204-4000
Fax Number : 775-204-4001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 03/23/2021

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