Provider Demographics
NPI:1922867746
Name:HICKS, JAILYN NOELLE (MD)
Entity type:Individual
Prefix:DR
First Name:JAILYN
Middle Name:NOELLE
Last Name:HICKS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:22250 PROVIDENCE DR STE 700
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-6215
Mailing Address - Country:US
Mailing Address - Phone:248-849-3401
Mailing Address - Fax:248-849-3401
Practice Address - Street 1:22250 PROVIDENCE DR STE 700
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-6215
Practice Address - Country:US
Practice Address - Phone:248-849-3401
Practice Address - Fax:248-849-4106
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2025-05-13
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Provider Licenses
StateLicense IDTaxonomies
MI4351054465207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology