Provider Demographics
NPI:1265657092
Name:HICKS, JAMES WHITNEY (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WHITNEY
Last Name:HICKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:KIRBY FORENSIC P.C., 1 EAST
Mailing Address - Street 2:WARDS ISLAND COMPLEX
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-6095
Mailing Address - Country:US
Mailing Address - Phone:646-672-5802
Mailing Address - Fax:
Practice Address - Street 1:KIRBY FORENSIC P.C.
Practice Address - Street 2:WARDS ISLAND COMPLEX
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-6095
Practice Address - Country:US
Practice Address - Phone:646-672-5802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2060192084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY206019Medicaid