Provider Demographics
NPI:1326512781
Name:HICKMAN, JOSHUA (PA-C)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:HICKMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1260 DOCTORS LN STE A
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4072
Mailing Address - Country:US
Mailing Address - Phone:970-286-2668
Mailing Address - Fax:970-294-4954
Practice Address - Street 1:1260 DOCTORS LN STE A
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4072
Practice Address - Country:US
Practice Address - Phone:970-286-2668
Practice Address - Fax:970-294-4954
Is Sole Proprietor?:No
Enumeration Date:2019-01-17
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical