Hicks, Jason
Hicks, Jason is an individual health care provider with primary practice located at 6919 Old Canton Rd , Ridgeland MS 39157-1268. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Hicks, Jason can be contacted via phone (601) 956-0911.Contact Information
Primary practice address
6919 Old Canton Rd
Ridgeland MS 39157-1268
Phone: (601) 956-0911
Fax: (601) 957-8439
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 18937 | Mississippi |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 18937 | Mississippi |
Profile Details
| NPI number | 1023034097 |
|---|---|
| LBN Legal business name | Hicks, Jason |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2006 |
| Last updated | Dec 27th, 2013 - about 13 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 | 1023034097 | NPPES |
| Mississippi | MEDICAID | 0629768 |
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