Randy Lee Hicks Jr.
Randy Lee Hicks Jr. is a Physician Assistant in LA Fayette, Georgia. Qualified in 2021, 5 years ago. Practices with Southland Consolidated Emergency Services LLC, a 67-clinician group and accepts Medicare assignment. Licensed in Georgia.
- Years since qualifying
- 5
- Licensed in
- GA
- In the registry since
- 2021
- Specialties on file
- 2
Practice location Address checks out
95 Sullivan LnLA Fayette, GA 30728-1500
Phone: (423) 298-5079
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 10641 (GA) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1841880655 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | January 25, 2021 |
| Last updated in NPPES | October 13, 2021 |
| Certification date | October 13, 2021 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2021 (5 years in practice) |
| Group practice | Southland Consolidated Emergency Services Llc — 67 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |
Other providers in LA Fayette
-
Ashton Stalling
10 Probasco St, LA Fayette, GA 30728-2301 · (706) 719-0888