Kevin R Hickman

NPI #1407903966 in Bremen, Indiana

Provider Information

NPI Number: 1407903966
Entity Type: Organization
Organization Name: Kevin R Hickman
Primary Specialty: Optometrist
Enumeration Date: Jan 5, 2007
Last Updated: Feb 22, 2008

Practice Location

Address: 122 W PLYMOUTH ST
City: Bremen
State: Indiana
ZIP Code: 46506-1543
Phone: (574) 546-4400

Authorized Official

Name: DR. KEVIN R HICKMAN, O.D.
Title: OWNER
Phone: (574) 546-4400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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