Hicks, John R.
Hicks, John R. is an sole proprietor health care provider with primary practice located at 5046 Highway 17 Byp S Suite 100, Myrtle Beach SC 29588-4503. He recently has 4 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Hicks, John R. can be contacted via phone (843) 293-5100.Contact Information
Primary practice address
5046 Highway 17 Byp S Suite 100
Myrtle Beach SC 29588-4503
Phone: (843) 293-5100
Fax: (843) 293-5101
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 14089 | South Carolina |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 14089 | South Carolina |
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | 14089 | South Carolina |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 14089 | South Carolina |
Profile Details
| NPI number | 1528017951 |
|---|---|
| LBN Legal business name | Hicks, John R. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 10th, 2006 |
| Last updated | Jun 27th, 2014 - about 10 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 | 1528017951 | NPPES |
| South Carolina | MEDICAID | 140895 | |
| South Carolina | MEDICAID | GP0749 |
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