| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MASON H HICKS | 1851603062 | 2024-07-04 |
Mason H Hicks [M] graduated in 2010 and primarily specializes in Physician Assistant.
Mason H Hicks is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1851603062. Registration indicates Mason H Hicks is a provider of services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant (Physician Assistant: Surgical, ) (All Other Specialties & Provider Types, ) (Physician Assistant Surgical Technologist, Physician Assistants & Advanced Practice Nursing Providers) (Physician Assistant, ) Access to Adult/Geriatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| PECOS ID | 7911188677 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Mason H Hicks PA-C |
| Practice Office Address | 5147 N 9TH AVE STE 103 PENSACOLA, FL US |
| Practice Office Telephone | 8504949000 |
| Practice Office Fax | 8504161912 |
| Mailing Address | 1017 FAIRNIE AVE PENSACOLA, FL 325035313 US |
| Business Telephone | 8438220711 |
| Code | Practice | License No State |
|---|---|---|
| 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant: Surgical All Other Specialties & Provider Types Physician Assistant Surgical Technologist Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | MPA1559
SC |
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | PA9111053
FL |
| 0242695-00 | MEDICAID | FL | |
| PA9111053 | OTHER | FL | FL MEDICAL LICE |