Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Fred Wayne Hicks Jr., MD

Individual provider Family Medicine Physician · NPI 1982353124

Fred Wayne Hicks Jr., MD is a Family Practice in Bristol, Tennessee. Graduated from East Tennessee State University Quillen College of Medicine in 2022, 4 years ago. Practices with Southeastern Physician Services PC, a 598-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
4
Trained at
East Tennessee State University Quillen College of Medicine
Licensed in
FL
In the registry since
2022
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

208 Medical Park Blvd
Bristol, TN 37620-7343
Phone: (423) 989-4050
Fax: (423) 990-3044
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 74888 (FL)

Record details

NPI number1982353124
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 23, 2022
Last updated in NPPESAugust 4, 2025
Certification dateAugust 4, 2025
Mailing address208 Medical Park Blvd, Bristol, TN 37620-7343

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolEAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE
Graduated 2022 (4 years in practice)
Group practice Southeastern Physician Services Pc — 598 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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