Provider Demographics
NPI:1932161676
Name:PEYTON E RICE MD UROLOGY PA
Entity Type:Organization
Organization Name:PEYTON E RICE MD UROLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PEYTON
Authorized Official - Middle Name:E
Authorized Official - Last Name:RICE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:501-753-4593
Mailing Address - Street 1:3401 SPRINGHILL DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2924
Mailing Address - Country:US
Mailing Address - Phone:501-753-4593
Mailing Address - Fax:501-753-6713
Practice Address - Street 1:3401 SPRINGHILL DR
Practice Address - Street 2:SUITE 240
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2924
Practice Address - Country:US
Practice Address - Phone:501-753-4593
Practice Address - Fax:501-753-6713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARMC0774Medicare PIN
DN6728Medicare PIN