Hicks, Cory Joseph
Hicks, Cory Joseph is an sole proprietor health care provider with primary practice located at 4901 Lang Ave Ne , Albuquerque NM 87109-4495. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Hicks, Cory Joseph can be contacted via phone (505) 842-8171.Contact Information
Primary practice address
4901 Lang Ave Ne
Albuquerque NM 87109-4495
Phone: (505) 842-8171
Fax: (505) 246-0684
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | BP10027616 | Texas |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | N7105 | Texas |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | N7105 | Texas |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | N7105 | Texas |
Profile Details
| NPI number | 1588863450 |
|---|---|
| LBN Legal business name | Hicks, Cory Joseph |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 12th, 2007 |
| Last updated | May 15th, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588863450 | NPPES |
| New Mexico | MEDICAID | 55236251 | |
| New Mexico | Other | N7105 | |
| New Mexico | Other | MD2014-0172 |
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