Fred Wayne Hicks Jr., MD
Family Medicine in Bristol, TN. Individual provider (NPI-1).
NPI number1982353124
StatusActive
Last updated in NPPESAug 4, 2025
Details
- NPI
- 1982353124
- Entity type
- Individual (NPI-1)
- Name
- Fred Wayne Hicks Jr.
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 23, 2022
- Certification date
- Aug 4, 2025
- Last updated
- Aug 4, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 74888 | FL | Yes |
Practice location
208 Medical Park BlvdBristol, TN 37620-7343
Phone 423-989-4050 · Fax 423-990-3044
Mailing address
208 Medical Park BlvdBristol, TN 37620-7343
Phone 423-989-4050 · Fax 423-990-3044
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