Healthcare Provider Details

I. General information

NPI: 1881807626
Provider Name (Legal Business Name): ANDREW J RICE MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 WOODLAND DR
COOS BAY OR
97420-2099
US

IV. Provider business mailing address

1900 WOODLAND DR
COOS BAY OR
97420-2099
US

V. Phone/Fax

Practice location:
  • Phone: 541-267-5151
  • Fax:
Mailing address:
  • Phone: 541-267-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA102056
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD176443
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: