Healthcare Provider Details

I. General information

NPI: 1386879484
Provider Name (Legal Business Name): JILL ALISON SICKLES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILL HOBBS MD

II. Dates (important events)

Enumeration Date: 05/19/2009
Last Update Date: 02/10/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3615 19TH ST
LUBBOCK TX
79410-1203
US

IV. Provider business mailing address

3615 19TH ST
LUBBOCK TX
79410-1203
US

V. Phone/Fax

Practice location:
  • Phone: 888-804-3000
  • Fax:
Mailing address:
  • Phone: 888-804-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD2013-0411
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: