Provider Demographics
NPI:1902800501
Name:RICE, PHILIP L (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:L
Last Name:RICE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 RADNOR RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7986
Mailing Address - Country:US
Mailing Address - Phone:814-238-2616
Mailing Address - Fax:814-238-0541
Practice Address - Street 1:100 RADNOR RD
Practice Address - Street 2:SUITE 201
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7986
Practice Address - Country:US
Practice Address - Phone:814-238-2616
Practice Address - Fax:814-238-0541
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2011-05-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD060088L208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016582690003Medicaid
PAC02020Medicare UPIN
PA0016582690003Medicaid