Hickerson, William Leslie

Hickerson, William Leslie is an individual health care provider with primary practice located at 890 Madison Ave Suite Tg032, Memphis TN 38103-3409. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgical Critical Care, Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery is his primary health care specialty. Hickerson, William Leslie can be contacted via phone (901) 448-2579.

Contact Information

Primary practice address
890 Madison Ave Suite Tg032 Memphis TN 38103-3409
Phone: (901) 448-2579
Fax: (901) 448-2602
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X E-4374 Arkansas
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X E-4374 Arkansas
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 12709 Tennessee

Profile Details

NPI number 1033209606
LBN Legal business name Hickerson, William Leslie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated Oct 8th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033209606 NPPES
Mississippi MEDICAID 00154377
Mississippi MEDICAID 1033209606
Mississippi MEDICAID 111048001
Mississippi MEDICAID 177555
Mississippi MEDICAID 3001590
Mississippi MEDICAID 003179306A

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