Provider Demographics
NPI:1164436952
Name:RICE, JOHN BAYARD (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:BAYARD
Last Name:RICE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:189 OUTER LOOP
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-5544
Practice Address - Country:US
Practice Address - Phone:502-363-1731
Practice Address - Fax:502-364-9272
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY24705207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1676773OtherCIGNA / NCMA
KY000028412AOtherHUMANA / NCMA
KY019321OtherSIHO / NCMA
KY1200096OtherCHA / NCMA
KY244059000OtherPASSPORT ADVANTAGE / NCMA
KY64247059Medicaid
KY1166616OtherPASSPORT / NCMA
IN200094920Medicaid
KY000000240875OtherANTHEM / NCMA
KY110242746OtherRAILROAD MEDICARE
KY0361985Medicare PIN
KY244059000OtherPASSPORT ADVANTAGE / NCMA