Hickerson, Stuart
Hickerson, Stuart is an individual health care provider with primary practice located at 12528 Sr 78 , Havana IL 62644-6866. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Hickerson, Stuart can be contacted via phone (309) 543-4253.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | 036083126 | Illinois |
Profile Details
| NPI number | 1073629374 |
|---|---|
| LBN Legal business name | Hickerson, Stuart |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 21st, 2006 |
| Last updated | Apr 24th, 2013 - about 11 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 | 1073629374 | NPPES |
| Illinois | MEDICAID | 036083126 |
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