Provider Demographics
NPI:1780836643
Name:WILLIAM A TRICE MD PA
Entity Type:Organization
Organization Name:WILLIAM A TRICE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ADAMSON
Authorized Official - Last Name:TRICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-732-5211
Mailing Address - Street 1:2723 SE MARICAMP RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5537
Mailing Address - Country:US
Mailing Address - Phone:352-732-5211
Mailing Address - Fax:352-629-5391
Practice Address - Street 1:2723 SE MARICAMP RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5537
Practice Address - Country:US
Practice Address - Phone:352-732-5211
Practice Address - Fax:352-629-5391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0025927261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0025927OtherFL LICENSE
FL78906OtherPTAN
FL1093797714OtherNPI - SOLE PROPRIETOR