Provider Demographics
NPI:1295782662
Name:HICKS, WAYNE D (DC)
Entity type:Individual
Prefix:
First Name:WAYNE
Middle Name:D
Last Name:HICKS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 562
Mailing Address - Street 2:
Mailing Address - City:S YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02664-0562
Mailing Address - Country:US
Mailing Address - Phone:508-398-6593
Mailing Address - Fax:
Practice Address - Street 1:24 ROUTE 134 UNIT 3
Practice Address - Street 2:
Practice Address - City:SOUTH DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02660-3739
Practice Address - Country:US
Practice Address - Phone:508-394-1625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2727111N00000X
247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAU93324Medicare UPIN
MAHIY45581Medicare ID - Type Unspecified