Healthcare Provider Details

I. General information

NPI: 1285195297
Provider Name (Legal Business Name): ROBERT CHACE HICKS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2019
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

979 E 3RD ST STE 300
CHATTANOOGA TN
37403-2187
US

IV. Provider business mailing address

979 E 3RD ST STE 300
CHATTANOOGA TN
37403-2187
US

V. Phone/Fax

Practice location:
  • Phone: 423-267-0466
  • Fax: 423-757-0790
Mailing address:
  • Phone: 423-267-0466
  • Fax: 423-757-0790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number246933
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number246933
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: