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General NPI Number Information
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NPI Number | 1326044520
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Entity Type | Individual
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Provider Name | RONALD B. HICKS II MD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 03/23/2021
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Provider Practice Location Address
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Address Line | 5975 S LOS ALTOS PKWY
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City | SPARKS
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State | NV
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Zip | 89436-7699
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Country | US
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Telephone | 775-204-4000
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Fax | 775-204-4001
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Provider Business Mailing Address
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Address Line | 2345 E PRATER WAY STE 301
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City | SPARKS
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State | NV
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Zip | 89434-9639
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Country | US
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Telephone | 775-352-3520
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Fax | 775-352-3523
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 7996
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License Number State | NV
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