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General NPI Number Information
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NPI Number | 1265991327
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Entity Type | Individual
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Provider Name | CHANDLER HICKS
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Gender | Male
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 920 STANTON L YOUNG BLVD OFC 3038
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5036
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Country | US
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Telephone | 918-237-8484
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Fax |
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Provider Business Mailing Address
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Address Line | 920 STANTON L YOUNG BLVD # 3038
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5036
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 3962
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 58.030898
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License Number State | OH
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