Hicks, Stanley Michael

Hicks, Stanley Michael is an individual health care provider with primary practice located at 700 Lincoln St Suite 100, Kelso WA 98626-1057. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Hicks, Stanley Michael can be contacted via phone (360) 425-5131.

Contact Information

Primary practice address
700 Lincoln St Suite 100 Kelso WA 98626-1057
Phone: (360) 425-5131
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD00029538 Washington

Profile Details

NPI number 1336129451
LBN Legal business name Hicks, Stanley Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2006
Last updated Jul 9th, 2007 - about 19 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 1336129451 NPPES
Washington MEDICAID 8136988
Washington Other 040803
Washington Other 34871

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