Provider Demographics
NPI:1811575228
Name:PINNACLE MEDICAL GROUP HICKS PC
Entity Type:Organization
Organization Name:PINNACLE MEDICAL GROUP HICKS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:B
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-352-3520
Mailing Address - Street 1:5975 S LOS ALTOS PKWY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-7699
Mailing Address - Country:US
Mailing Address - Phone:775-204-4000
Mailing Address - Fax:775-204-4001
Practice Address - Street 1:6630 S MCCARRAN BLVD STE 9
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6145
Practice Address - Country:US
Practice Address - Phone:775-204-4000
Practice Address - Fax:775-204-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty