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RANDY LEE HICKS

>> Organized Health Care Education/Training Program >> Student

Registrant NPI Number: 1841880655

Individual Registrant:
 RANDY LEE HICKS 
Gender: M
Sole Proprietor

Location and contact information for practice:
95 SULLIVAN LN  LA FAYETTE, GA 30728-1500 US
Tel: 423-298-5079  Fax: --

Contact information for business:
95 SULLIVAN LN  LA FAYETTE, GA 30728-1500 US
Tel: 423-298-5079  Fax: --

Registration Information:
NPI: 1841880655
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N390200000XStudent
Organized Health Care Education/Training Program
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
GA10641

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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