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NPI Code Detail

MEDICARE: THOMAS H HICKS MD

MEDICARE: THOMAS H HICKS 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
1174400000XSpecialist7244AZ
2208800000XUrology Physician7244AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679575922
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS H HICKS MD
Provider Business Mailing Address
First Line : 6325 E TANQUE VERDE RD
Second Line :
City : TUCSON
State : AZ
Zip : 85715-3808
Country : US
Telephone Number : 520-546-7137
Fax Number : 520-885-7396
Provider Business Practice Location Address
First Line : 6325 E TANQUE VERDE RD
Second Line :
City : TUCSON
State : AZ
Zip : 85715-3808
Country : US
Telephone Number : 520-546-7137
Fax Number : 520-885-7396
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 09/10/2014

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Directions to “ THOMAS H HICKS MD” Practice Location

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