Stephen A. Hickner, M.d., LLC

NPI #1003115577 in Lander, Wyoming

Provider Information

NPI Number: 1003115577
Entity Type: Organization
Organization Name: Stephen A. Hickner, M.d., LLC
Primary Specialty: Obstetrics & Gynecology
Enumeration Date: Mar 22, 2011
Last Updated: Mar 29, 2011

Practice Location

Address: 8160 HIGHWAY 789
City: Lander
State: Wyoming
ZIP Code: 82520-2953
Phone: (616) 633-8628

Authorized Official

Name: STEPHEN ANDREW HICKNER, M.D.
Title: REGISTERED AGENT
Phone: (616) 633-8628

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X	Primary

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