MEDICARE: DR. JOHN R. HICKS II 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
1	174400000X	Specialist	14089	SC
2	207RI0011X	Interventional Cardiology Physician	14089	SC
3	207RC0001X	Clinical Cardiac Electrophysiology Physician	14089	SC
4	207RC0000X	Cardiovascular Disease Physician	14089	SC

Other Identifiers

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

General Provider Information

NPI Number	:	1528017951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN R. HICKS II MD

Provider Business Mailing Address
First Line	:	5046 HIGHWAY 17 BYP S
Second Line	:	SUITE 100
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-4503
Country	:	US
Telephone Number	:	843-293-5100
Fax Number	:	843-293-5101

Provider Business Practice Location Address
First Line	:	5046 HIGHWAY 17 BYP S
Second Line	:	SUITE 100
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-4503
Country	:	US
Telephone Number	:	843-293-5100
Fax Number	:	843-293-5101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	06/27/2014

Similar Medicare Providers

1851928410 — DR. BRENT T FOLSOM MD
Practice Location Address:

5046 HIGHWAY 17 BYP S STE 200
MYRTLE BEACH, SC
29588-4503

Practice Phone: 843-839-3501
Practice Fax:

1023006178 — DR. GERY BRIAN KATALINICH DPM
Practice Location Address:

5046 HWY 17 BYP S , SUITE 102
MYRTLE BEACH, SC
29588-4503

Practice Phone: 843-293-6366
Practice Fax: 843-293-4469

1649269085 — GRAND STRAND SENIOR HEALTH CENTER, LLC
Practice Location Address:

5046 HIGHWAY 17 BYP S , SUITE 100
MYRTLE BEACH, SC
29588-4503

Practice Phone: 843-839-6192
Practice Fax: 843-839-6164

1295794386 — DR. GWENDOLYN PATTERSON COBBS M.D.
Practice Location Address:

5046 HIGHWAY 17 BYP S STE 202
MYRTLE BEACH, SC
29588-4503

Practice Phone: 843-293-0466
Practice Fax: 843-293-0534

1205883105 — HISHAM IBRAHIM BASSIOUNI PAC
Practice Location Address:

5046 HIGHWAY 17 BYP S STE 103
MYRTLE BEACH, SC
29588-4503

Practice Phone: 843-668-4104
Practice Fax:

1801810007 — DR. BRIAN KEITH ADLER MD
Practice Location Address:

5046 HIGHWAY 17 BYP S STE 205
MYRTLE BEACH, SC
29588-4503

Practice Phone: 843-314-1357
Practice Fax: 854-212-7381

Directions to “ DR. JOHN R. HICKS II MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.