Healthcare Provider Details

I. General information

NPI: 1922016898
Provider Name (Legal Business Name): JAMES TRICE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 01/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7005 S HAZEL ST
PINE BLUFF AR
71603-7833
US

IV. Provider business mailing address

PO BOX 25306
LITTLE ROCK AR
72221-5306
US

V. Phone/Fax

Practice location:
  • Phone: 870-536-3070
  • Fax: 870-536-3171
Mailing address:
  • Phone: 870-536-3070
  • Fax: 870-536-3171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberAR3073
License Number StateAR

VIII. Authorized Official

Name: DR. JAMES TRICE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 870-536-3070