Healthcare Provider Details

I. General information

NPI: 1942496955
Provider Name (Legal Business Name): ALICIA K GUICE MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2007
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10503 W THUNDERBIRD BLVD SUITE 112
SUN CITY AZ
85351
US

IV. Provider business mailing address

10503 W THUNDERBIRD BLVD SUITE 112
SUN CITY AZ
85351
US

V. Phone/Fax

Practice location:
  • Phone: 623-933-7900
  • Fax: 623-933-6883
Mailing address:
  • Phone: 623-933-7900
  • Fax: 623-933-6883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number28062
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number28062
License Number StateAZ

VIII. Authorized Official

Name: ALICIA KAYLE GUICE
Title or Position: OWNER
Credential: MD
Phone: 623-933-7900