Provider Demographics
NPI:1851371645
Name:HICKMAN, JAMES S (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:HICKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:31 HALL DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2751
Mailing Address - Country:US
Mailing Address - Phone:413-253-3773
Mailing Address - Fax:413-256-0215
Practice Address - Street 1:31 HALL DR
Practice Address - Street 2:SUITE 2
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2751
Practice Address - Country:US
Practice Address - Phone:413-253-3773
Practice Address - Fax:413-256-0215
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA60163208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2374898OtherAETNA
MAJ07595OtherBLUE CROSS AND BLUE SHIEL
MA060163OtherTUFTS HEALTH PLAN
MA24205OtherHEALTH NEW ENGLAND
MA27812OtherCHILDRENS MEDICAL SECURIT
MA601631OtherCONNECTICARE
MA3041964Medicaid
MA10140302OtherCIGNA
MA202075OtherHARVARD PILGRIM HEALTH CA
MA000000007634OtherBMC HEALTHNET
MAJ07595Medicare ID - Type Unspecified
MA3041964Medicaid