MEDICARE: PEYTON E RICE MD UROLOGY PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician		AR

General Provider Information

NPI Number	:	1932161676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEYTON E RICE MD UROLOGY PA

Provider Business Mailing Address
First Line	:	3401 SPRINGHILL DR
Second Line	:	SUITE 240
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72117-2924
Country	:	US
Telephone Number	:	501-753-4593
Fax Number	:	501-753-6713

Provider Business Practice Location Address
First Line	:	3401 SPRINGHILL DR
Second Line	:	SUITE 240
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72117-2924
Country	:	US
Telephone Number	:	501-753-4593
Fax Number	:	501-753-6713

Authorized Official
Title or Position	:	OWNER PHYSICIAN
Name	:	PEYTON E RICE JR.
Credential	:	MD
Telephone Number	:	501-753-4593

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	12/21/2010

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