Hicklin, D Mark

Hicklin, D Mark is an individual health care provider with primary practice located at 120 Heywood Ave Suite 200, Spartanburg SC 29302-1210. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hicklin, D Mark can be contacted via phone (864) 573-9595.

Contact Information

Primary practice address
120 Heywood Ave Suite 200 Spartanburg SC 29302-1210
Phone: (864) 573-9595
Fax: (864) 585-3752
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 11179 South Carolina

Profile Details

NPI number 1770553257
LBN Legal business name Hicklin, D Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Dec 13th, 2007 - about 17 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 1770553257 NPPES
South Carolina MEDICAID 111792
South Carolina Other 4584043
South Carolina Other 58864
South Carolina MEDICAID 7906539

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