Martin Tice MD

NPI 1407078629 - Emergency Medicine - 207P00000X

NPI Details
NPI 1407078629
Gender Male
Enumeration Date 05/03/2007
Last Updated 07/09/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1111 CRATER LAKE AVE
MEDFORD OR, 97504-6241, US
Phone (503) 215-4323
Fax (503) 215-0297
Business Location
PO BOX 3308
PORTLAND OR, 97208-3308, US
Phone (503) 125-4323
Fax (503) 215-0297
Toxanomy
Taxonomy Code 207P00000X
License State Oregon
License Number MD11348
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According to our database, Dr. Martin Tice MD NPI is 1407078629, taxonomy code is 207P00000X and license number is MD11348, license state is located at Oregon. Martin Tice MD physically located at 1111 Crater Lake Ave, Medford OR, 97504-6241. NPI Number Martin Tice MD has the Individual type.

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1407078629 NPI number is provided on an as is basis without warranty of any kind. 1407078629 is maintained by the National Plan & Provider Enumeration System. The contents of Martin Tice MD are for informational purposes only.