Bruce Edward Hickman, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

39580 Issued in WI

Practice address

1640 E Sumner St
Hartford, WI 53027

Phone

(262) 670-4000

Fax

(262) 670-4451

NPI assigned

Aug 23, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1083721609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W GOOD HOPE RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532092042",
            "telephone_number": "414-352-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 E SUMNER ST",
            "city": "HARTFORD",
            "state": "WI",
            "postal_code": "53027",
            "telephone_number": "262-670-4000",
            "fax_number": "262-670-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "BRUCE",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "39580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01115320",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Esteban Henriquez
• Karre M Hermann, NP
• Marianna M Herrera, CRNA
• Herslof'S, Inc
• Aleese Hetzel
• Mackenzie Ann Hicks, CCC-SLP
• Highland Chiropractic SC
• Amber Hildebrandt, M.D.
• Jonathan Hill
• Enisa Hodzic, M.D.

• Family Medicine Physician in Hartford, WI
• Providers in Hartford, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.