Provider Demographics
NPI:1679035158
Name:HICKS, MORGAN MCDANIEL (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:MCDANIEL
Last Name:HICKS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 N 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:SC
Mailing Address - Zip Code:29536-2503
Mailing Address - Country:US
Mailing Address - Phone:843-245-5781
Mailing Address - Fax:
Practice Address - Street 1:603 N 6TH AVE
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-2503
Practice Address - Country:US
Practice Address - Phone:843-774-7336
Practice Address - Fax:843-774-3745
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMPA.3193363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical