Active NPI
Mark Anthony Hicks, R.PH., B.C.P.S.
- Pharmacotherapy Pharmacist
- Douglasville, GA
National Provider Identifier
1871594861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 014863
- Practice address
- 929 Austin Bridge Rd
Douglasville, GA 30134-5138 - Phone
- (770) 656-3082
- Fax
- (678) 715-6113
- NPI assigned
- Aug 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 014863 | GA | Primary |
Addresses
Primary practice location
929 Austin Bridge Rd
Douglasville, GA 30134-5138
Mailing address
929 Austin Bridge Rd
Douglasville, GA 30134-5138
Phone (770) 656-3082
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014863 | GA | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1871594861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "929 AUSTIN BRIDGE RD",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301345138",
"telephone_number": "770-656-3082",
"fax_number": "678-715-6113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 AUSTIN BRIDGE RD",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301345138",
"telephone_number": "770-656-3082",
"fax_number": "678-715-6113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "MARK",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"credential": "R.PH., B.C.P.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-02",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "GA",
"license": "014863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.