MEDICARE: THOMAS CARLTON HICKS MD, MPH

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	208000000X	Pediatrics Physician	16965	AL

General Provider Information

NPI Number	:	1568392108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS CARLTON HICKS MD, MPH

Provider Business Mailing Address
First Line	:	7410 EWELL RD
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-1637
Country	:	US
Telephone Number	:	941-307-9975
Fax Number	:

Provider Business Practice Location Address
First Line	:	7410 EWELL RD
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-1637
Country	:	US
Telephone Number	:	941-307-9975
Fax Number	:

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

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	05/22/2026

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