Provider Demographics
NPI:1700307261
Name:HICKS, JOSEPH (APSS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:HICKS
Suffix:
Gender:M
Credentials:APSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-1582
Mailing Address - Country:US
Mailing Address - Phone:859-489-6557
Mailing Address - Fax:859-756-6078
Practice Address - Street 1:217 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:KY
Practice Address - Zip Code:40342-1178
Practice Address - Country:US
Practice Address - Phone:859-489-6557
Practice Address - Fax:859-756-6078
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist