All Ages Family Medicine, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35076870H Issued in OH

Legal business name

ALL AGES FAMILY MEDICINE, INC.

Practice address

241 Paddock CT
Delaware, OH 43015-1317

Phone

(740) 362-8686

Fax

(740) 363-4662

NPI assigned

Oct 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Hickman, M.D.

Title

President

Phone

(740) 362-8686

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1902095490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 PADDOCK CT",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151317",
            "telephone_number": "740-362-8686",
            "fax_number": "740-363-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 PADDOCK CT",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151317",
            "telephone_number": "740-362-8686",
            "fax_number": "740-363-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL AGES FAMILY MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-362-8686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35076870H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2256866",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Delaware, OH
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; 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.