MR. Jayson Douglas Hicks, PA

NPI #1881968972 in Champlin, Minnesota

Provider Information

NPI Number
1881968972
Entity Type
Individual
Name
MR. Jayson Douglas Hicks, PA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant - Medical
Credential
PA
Enumeration Date
Mar 7, 2012
Last Updated
Mar 7, 2012

Practice Location

Address
113 W RIVER PKWY
ZIP Code
55316-1316
Phone
(612) 801-2745

Specialties & Taxonomy Codes

Specialty
Physician Assistant - MedicalMedical

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