Most Relevant Information
Provider Data
| NPI Number: | 1003406067 |
| Provider Name: | TAMESHIA I HICKS |
| Entity Type: | Individual |
| Taxonomy Code: | 1744P3200X |
| Specialty: | Specialist |
| License Number: | CL1185672 |
Most Important Dates
| Enumeration Date: | 01/24/2021 |
| Last Updated: | 01/24/2021 |
Provider Practice Location
8036 PHILIPS HWY STE 4
JACKSONVILLE
FL
322567466
Practice Location Phone/Fax
| Phone: | 9042335471 |
| Fax: |
Provider Mailing Location
1743 CAVALCADE CT
JACKSONVILLE
FL
322186227
Provider Mailing Phone/Fax
| Phone: | 9042335471 |
| Fax: |