Provider Demographics
NPI:1265538235
Name:RICE, NICHOLAS H (MD)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:H
Last Name:RICE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 10880
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86304-0880
Mailing Address - Country:US
Mailing Address - Phone:928-759-5987
Mailing Address - Fax:928-458-2039
Practice Address - Street 1:3120 CLEARWATER DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7131
Practice Address - Country:US
Practice Address - Phone:928-771-3704
Practice Address - Fax:928-771-0434
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2022-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ23717207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ329301Medicaid
AZG20708Medicare UPIN
AZG20708Medicare UPIN