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General NPI Number Information
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NPI Number | 1477661635
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Entity Type | Individual
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Provider Name | CHRISTOPHER JOE HICKS C.R.N.A.
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Gender | Male
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 993-D JOHNSON FERRY RD. SUITE 300
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City | ATLANTA
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State | GA
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Zip | 30342
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Country | US
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Telephone | 404-250-1153
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Fax |
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Provider Business Mailing Address
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Address Line | 110 STARBOARD WAY
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City | ALPHARETTA
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State | GA
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Zip | 30022-4499
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Country | US
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Telephone | 404-578-5263
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN137958
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License Number State | GA
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