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NPI Code Detail

MEDICARE: DR. TERRY R HICKS MD

MEDICARE: DR. TERRY R HICKS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician2472SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20006262OTHERSDBCBS

General Provider Information

NPI Number : 1124017629
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERRY R HICKS MD
Provider Business Mailing Address
First Line : 350 ELK ST
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-7351
Country : US
Telephone Number : 605-343-7262
Fax Number : 605-343-7293
Provider Business Practice Location Address
First Line : 350 ELK ST
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-7351
Country : US
Telephone Number : 605-343-7262
Fax Number : 605-343-7293
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 01/05/2015

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