Provider Demographics
NPI:1639131501
Name:TICE, FRANK D IV (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:D
Last Name:TICE
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:2570 ABINGTON RD
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43221-3004
Mailing Address - Country:US
Mailing Address - Phone:614-486-7165
Mailing Address - Fax:
Practice Address - Street 1:745 W STATE ST
Practice Address - Street 2:STE 750
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43222-1515
Practice Address - Country:US
Practice Address - Phone:614-224-2281
Practice Address - Fax:614-221-8869
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056291T207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
2500396OtherUNITED HEALTHCARE
00000000014654OtherANTHEM BCBS
060038976OtherRAILROAD MEDICARE
10600OtherNATIONWIDE
289254OtherBLACK LUNG
9721935OtherCIGNA
OH0761126Medicaid
9721935OtherCIGNA
2500396OtherUNITED HEALTHCARE
TI0647539Medicare ID - Type Unspecified