Healthcare Provider Details

I. General information

NPI: 1841237377
Provider Name (Legal Business Name): JILL HICKEY DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 8TH ST N
NAPLES FL
34102-6020
US

IV. Provider business mailing address

49 8TH ST N
NAPLES FL
34102-6020
US

V. Phone/Fax

Practice location:
  • Phone: 239-436-1999
  • Fax: 239-436-3788
Mailing address:
  • Phone: 239-436-1999
  • Fax: 239-436-3788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: JILL V HICKEY
Title or Position: OWNER
Credential: DPM
Phone: 239-436-1999