Provider Demographics
NPI:1285818906
Name:JAMES E. HICKS, D.C., INC.
Entity Type:Organization
Organization Name:JAMES E. HICKS, D.C., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-864-1611
Mailing Address - Street 1:PO BOX 268
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-0268
Mailing Address - Country:US
Mailing Address - Phone:614-864-1611
Mailing Address - Fax:614-864-4573
Practice Address - Street 1:6400 E MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2359
Practice Address - Country:US
Practice Address - Phone:614-864-1611
Practice Address - Fax:614-864-4573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2246111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHJA9332221Medicare PIN