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NPI Code Detail

MEDICARE: MR. BRADLEY MARK HICKS RN

MEDICARE: MR. BRADLEY MARK HICKS RN
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
1163W00000XRegistered Nurse1-176346AL

General Provider Information

NPI Number : 1609718576
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRADLEY MARK HICKS RN
Provider Business Mailing Address
First Line : 50 MEDICAL PARK DR E
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35235-3401
Country : US
Telephone Number : 205-999-4740
Fax Number :
Provider Business Practice Location Address
First Line : 50 MEDICAL PARK DR E
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35235-3401
Country : US
Telephone Number : 205-838-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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