| Doctor Name: | DR. JEFFERY CHARLES HICKMAN |
| NPI Number: | 1598999757 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.C., P.A.-C |
| License Number: | 1298 |
| Business Practice Address: | Rr 3 Box 81c Walters, OK - 735729501 |
| Business Phone Number: | 5808752800 |
| Business Fax Number: | |
| Mailing Address: | 13811 Sw Baseline Rd, FAXON |
| State: | OK |
| Postal Code: | 735404418 |
| Phone Number: | 5805103005 |
| Fax Number: | |
| NPI Enumeration Date: | 05/03/2009 |
| NPI Last Update Date: | 02/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 1298 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |