Healthcare Provider Details

I. General information

NPI: 1134231822
Provider Name (Legal Business Name): ANGELA YVONNE RICE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 MARIE LANGDON DR STE 2
MANCHESTER KY
40962-6345
US

IV. Provider business mailing address

509 MEMORIAL DR STE 2
MANCHESTER KY
40962-6196
US

V. Phone/Fax

Practice location:
  • Phone: 606-599-9955
  • Fax:
Mailing address:
  • Phone: 606-599-9955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number02905
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number02905
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number02905
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number02905
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number02905
License Number StateKY
# 6
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02905
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: