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General NPI Number Information
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NPI Number | 1518967793
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Entity Type | Individual
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Provider Name | MICHAEL J HICKHAM MD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 06/08/2024
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Provider Practice Location Address
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Address Line | 3019 N ARNOULT RD
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City | METAIRIE
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State | LA
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Zip | 70002-4714
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Country | US
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Telephone | 504-889-5335
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Fax | 504-889-5451
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Provider Business Mailing Address
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Address Line | 3019 N ARNOULT RD
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City | METAIRIE
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State | LA
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Zip | 70002-4714
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Country | US
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Telephone | 504-889-5335
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Fax | 504-702-1922
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 10820R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 10820R
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License Number State | LA
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