Provider Demographics
NPI:1356349898
Name:RICE, JAMES M (RHD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:RICE
Suffix:
Gender:M
Credentials:RHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9780 LANTERN RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-4092
Mailing Address - Country:US
Mailing Address - Phone:317-578-4213
Mailing Address - Fax:317-578-9511
Practice Address - Street 1:9780 LANTERN RD
Practice Address - Street 2:SUITE 210
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-4092
Practice Address - Country:US
Practice Address - Phone:317-578-4213
Practice Address - Fax:317-578-9511
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040062A103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN521150DMedicare ID - Type Unspecified
INR76765Medicare UPIN