| Doctor Name: | MR. ALVIN T RICKS |
| NPI Number: | 1225106701 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APRN,BC |
| License Number: | R801797 |
| Business Practice Address: | 210 Hospital Cir Choctaw, MS - 393506781 |
| Business Phone Number: | 6016562211 |
| Business Fax Number: | 6013896391 |
| Mailing Address: | 210 Hospital Cir, CHOCTAW |
| State: | MS |
| Postal Code: | 393506781 |
| Phone Number: | 6016562211 |
| Fax Number: | 6013896391 |
| NPI Enumeration Date: | 12/01/2006 |
| NPI Last Update Date: | 03/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R801797 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |