John L Hicks
Oral and Maxillofacial Pathology
1702 University Dr S
Fargo
, North Dakota 58103-4940
John L Hicks
Oral and Maxillofacial Pathology
1702 University Dr S
Fargo
, North Dakota 58103-4940
(701) 364-8906
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- John L Hicks
- Po Box 6001
- Fargo, ND
- Zip : 58108-6001
- Fax : (701) 364-8906
- Phone : (701) 364-3300
Second Address
- John L Hicks
- 1702 University Dr S
- Fargo, ND
- Zip : 58103-4940
- Fax : (701) 364-8906
- Phone : (701) 364-3300
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 1496 | ND |
National Provider Identifier
| NPI | 1740215573 |
|---|---|
| Provider Name | John L Hicks |
| First Address | Fargo, ND 58108-6001 |
| Second Address | Fargo, ND 58103-4940 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/07/2006 |
| Last Update Date | 17/08/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 17823 | (05) | ND |
| 271817100 | (05) | ND |
| 40625 | (05) | ND |
| 4300108 | MEDICA # (01) | ND |
| 6016 | NDBS # (01) | ND |
| 61203HI | MNBS # (01) | ND |
| 676707 | AMERICA'S PPO/ARAZ # (01) | ND |
| 6864 | SIOUX VALLEY # (01) | ND |
| 8600254 | MEDICA # (01) | ND |
| DA9011026971 | PREFERRED ONE # (01) | ND |
| HP38190 | HEALTHPARTNERS # (01) | ND |
| ND200021 | LHS # (01) | ND |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.