Individual provider · Type 1 NPI
Jayson Douglas Hicks, PA
Medical Physician Assistant · Champlin, MN
NPI number
1881968972
Active
Practice location
113 W River Pkwy
Champlin, MN 55316-1316
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA954 (NV) |
Medical Physician Assistant: Definition to come...
About NPI 1881968972
Jayson Douglas Hicks, PA's National Provider Identifier is 1881968972, issued on Mar 7, 2012. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Champlin, MN. The record was last updated on Mar 7, 2012.