Provider Demographics
NPI:1316023708
Name:ABOKO-COLE HICKS, VIVIAN CHAMBERS (MD)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:CHAMBERS
Last Name:ABOKO-COLE HICKS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4000 BALMORAL DR SW
Mailing Address - Street 2:STE 101
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-7431
Mailing Address - Country:US
Mailing Address - Phone:256-533-3525
Mailing Address - Fax:256-533-3242
Practice Address - Street 1:4000 BALMORAL DR SW
Practice Address - Street 2:STE 101
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-7431
Practice Address - Country:US
Practice Address - Phone:256-533-3525
Practice Address - Fax:256-533-3242
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2019-04-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL4144207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4144OtherSTATE MEDICAL LICENSE
AL14-1840905OtherFEDERAL TAX ID
AL51513859OtherBLUECROSS/BLUESHIELD