Provider Demographics
NPI:1124164199
Name:HICKS, ARNIE RAY JR (DC)
Entity type:Individual
Prefix:DR
First Name:ARNIE
Middle Name:RAY
Last Name:HICKS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HWY 431
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:TN
Mailing Address - Zip Code:38237
Mailing Address - Country:US
Mailing Address - Phone:731-587-6613
Mailing Address - Fax:731-587-9491
Practice Address - Street 1:101 HWY 431
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237
Practice Address - Country:US
Practice Address - Phone:731-587-6613
Practice Address - Fax:731-587-9491
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001533111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
2486202OtherCIGNA COMMUCIDENT
3125569OtherBCBS OF TN
2486202OtherCIGNA COMMUCIDENT
3970579Medicare ID - Type Unspecified