Provider Demographics
NPI:1134429566
Name:RICKS, HOYLAND HARRIS (MD)
Entity type:Individual
Prefix:
First Name:HOYLAND
Middle Name:HARRIS
Last Name:RICKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 PEACHTREE ST NE
Mailing Address - Street 2:UNIT 902
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-6800
Mailing Address - Country:US
Mailing Address - Phone:404-872-0017
Mailing Address - Fax:
Practice Address - Street 1:11675 GREAT OAKS WAY
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-2421
Practice Address - Country:US
Practice Address - Phone:770-346-5138
Practice Address - Fax:888-521-2881
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA45599207Q00000X
IL036057173207Q00000X
ALMD.24022207Q00000X
FLME84432207Q00000X
MDD58739207Q00000X
NC200100599207Q00000X
SC22722207Q00000X
TN35657207Q00000X
LAMD.14336R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine