| Dr Jennifer O Hicks, MD | |
|
276 Nissan Pkwy, Building E Suite 100, Canton, MS 39046-7006 | |
| (601) 855-4880 | |
| (601) 859-2995 |
| Full Name | Dr Jennifer O Hicks |
|---|---|
| Gender | Female |
| Speciality | Obstetrics/gynecology |
| Experience | 48 Years |
| Location | 276 Nissan Pkwy, Canton, Mississippi |
| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649231408 | NPI | - | NPPES |
| D00992 | Other | MS | UPIN |
| 00114331 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 09855 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Merit Health Madison | Canton, MS | Hospital |
| University Of Mississippi Med Center | Jackson, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mallory Community Health | 9739074501 | 11 |
| Entity Name | Madison Hma Physician Management Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740359249 PECOS PAC ID: 1355444035 Enrollment ID: O20070319000178 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jennifer O Hicks, MD 276 Nissan Pkwy, Building E Suite 100, Canton, MS 39046-7006 Ph: (601) 855-4880 | Dr Jennifer O Hicks, MD 276 Nissan Pkwy, Building E Suite 100, Canton, MS 39046-7006 Ph: (601) 855-4880 |
Dr. Maria Moman Moman, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 1668 W Peace Street, Canton, MS 39046 Phone: 601-859-5213 Fax: 601-859-8771 | |
Dr. Wesley F Prater, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1668 W Peace St, Canton, MS 39046 Phone: 601-859-5213 Fax: 601-859-8771 |