Holly Hicks-Deridder in Newnan - Medical
Holly Hicks-Deridder - NPI 1578641627
Holly Hicks-Deridder is a Medical in Newnan, Georgia. Holly Hicks-Deridder practices all healthcare services and medical treatments related to Medical. The NPI Number for Holly Hicks-Deridder is 1578641627. The last update date is 2011-11-01.
Holly Hicks-Deridder's current location address is 2700 Highway 34 E Bldg 300, Newnan, Georgia. You can contact this provider via phone number 7703040987 and fax number 7702510938. The mailing address for Holly Hicks-Deridder is 2700 Highway 34 E Bldg 300, Newnan, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Holly Hicks-Deridder |
|---|---|
| Address | 2700 Highway 34 E Bldg 300, Newnan, Georgia |
| Phone Number | 7703040987 |
| Fax Number | 7702510938 |
| Sole Proprietor | Y |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1578641627 |
|---|---|
| Provider Enumeration Date | 2006-11-02 |
| Last Updated Date | 2011-11-01 |
Provider Mailing Address Detail
| Address | 2700 Highway 34 E Bldg 300 |
|---|---|
| City | Newnan |
| State | Georgia (GA) |
| Post Code | 302651330 |
| Phone Number | 7703040987 |
| Fax Number | 7702510938 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | 3338 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100002196A | GA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Holly Hicks-Deridder by the Centers for Medicare & Medicaid Services?
The Holly Hicks-Deridder has been assigned the NPI (National Provider Identifier) 1578641627 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please share the complete physical address where Holly Hicks-Deridder is geographically located?
The Holly Hicks-Deridder is physically situated at the following location: 2700 Highway 34 E Bldg 300, Newnan, GA, 302651330.
What is Holly Hicks-Deridder's area of expertise and its corresponding taxonomy classification?
The Holly Hicks-Deridder's field of specialization is Medical, and it falls under the taxonomy code 363Am0700X, which categorizes healthcare providers based on their areas of practice.
On what date did the Holly Hicks-Deridder receive its 1578641627 assignment from the Centers for Medicare & Medicaid Services?
The Holly Hicks-Deridder was assigned its 1578641627 by the Centers for Medicare & Medicaid Services on 2006-11-02.
As of what date were the details related to Holly Hicks-Deridder most recently updated or revised?
The information pertaining to Holly Hicks-Deridder, including its address, specialty, and other relevant details, was last updated or revised on 2011-11-01.