Healthcare Provider Details

I. General information

NPI: 1922700897
Provider Name (Legal Business Name): SAMUEL RICE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 MADISON AVE STE 1031
MEMPHIS TN
38103-3403
US

IV. Provider business mailing address

55 LAKE AVE N
WORCESTER MA
01655-0002
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-5529
  • Fax:
Mailing address:
  • Phone: 508-334-9750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number3017142
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: