=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891444378
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JUSTIN RICE MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2022
-----------------------------------------------------
Last Update Date | 01/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10649 BENNETT PKWY
-----------------------------------------------------
City | ZIONSVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46077-7849
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-873-6700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12950 OLD MERIDIAN ST APT 2031
-----------------------------------------------------
City | CARMEL
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46032-1981
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-652-0390
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 01096494A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------