Hicks, Benjamin Matthew

Hicks, Benjamin Matthew is an individual health care provider with primary practice located at 7601 W Jefferson Blvd , Fort Wayne IN 46804-4133. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Trauma, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Trauma is his primary health care specialty. Hicks, Benjamin Matthew can be contacted via phone (260) 436-8686.

Contact Information

Primary practice address
7601 W Jefferson Blvd Fort Wayne IN 46804-4133
Phone: (260) 436-8686
Fax: (260) 436-8585
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Trauma 207XX0801X 01046509A Indiana
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 01046509A Indiana

Profile Details

NPI number 1780687707
LBN Legal business name Hicks, Benjamin Matthew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Nov 3rd, 2016 - about 9 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 1780687707 NPPES
Other 00000089400 ANTHEM
Other 200032481 ANTHEM
MEDICAID 200089330A ANTHEM

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