Hicks, Thomas Glenn

Hicks, Thomas Glenn is an individual health care provider with primary practice located at 601 John St Box 42, Kalamazoo MI 49007-5341. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Hicks, Thomas Glenn can be contacted via phone (269) 341-6417.

Contact Information

Primary practice address
601 John St Box 42 Kalamazoo MI 49007-5341
Phone: (269) 341-6417
Fax: (269) 341-8743
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 4301035006 Michigan

Profile Details

NPI number 1700986965
LBN Legal business name Hicks, Thomas Glenn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Mar 27th, 2014 - about 12 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 1700986965 NPPES
Michigan Other 0C910950 BCBSM
Michigan MEDICAID 1700986965 BCBSM
Michigan Other TH035006 BCBSM

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