GREGORY KEITH TICE


Address: 1118 Ross Clark Cir Ste 704, Dothan, AL 36301-3030
Phone: 3346996396

GREGORY KEITH TICE (NPI# 1700344488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1700344488
Entity Type Individual
Full Name GREGORY KEITH TICE
Credential NP-C
Practice Address 1118 Ross Clark Cir Ste 704
Dothan
AL 36301-3030
Mailing Address 512 Mohawk Ave
Dothan
AL 36301-2222
Practice Telephone 3346996396
Mailing Telephone 3347905694
Enumeration Date 2019-03-12
Last Update Date 2019-03-12
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
1-074520 AL Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1118 ROSS CLARK CIR STE 704
City DOTHAN
State AL
Zip Code 36301-3030

Providers in the same location

NPI Name Taxonomy Address Enumeration
1760049787 Nicole D Hallford Nurse Practitioner 1118 Ross Clark Cir Ste 704, Dothan, AL 36301-3030 2019-05-24

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1043862931 Pharmacy Center South LLC Pharmacy 2826 Ross Clark Circle, Suite 103, Dothan, AL 36301 2019-07-11
1851879167 Attallah Cotton Social Worker 101 Eastridge Dr, Dothan, AL 36301 2018-07-31
1225522709 Nichole Johnson Prestwood Nurse Practitioner 2431 W Main St Ste 501, Dothan, AL 36301 2018-06-19
1750805818 Kimberly Danielle Austin Speech-Language Pathologist 404 Darlington Cir, Dothan, AL 36301 2017-07-31
1952794885 Lori P. Granberry Pharmacist 2131 Ross Clark Circle, Dothan, AL 36301 2015-03-17
1801286059 Robert Cody Russell Nurse Practitioner 1118 Ross Clark Circle, Suite 100, Dothan, AL 36301 2015-01-27
1720407646 Michael Kreger Anesthesiology 1118 Ross Clark Cir Ste 700, Dothan, AL 36301 2014-04-08
1063851277 Carlos Stanford Clark II Family Medicine 201 Doctors Drive, Dothan, AL 36301 2013-06-20
1639489313 Robert Fort Hambaugh Jr. Specialist 712 Woodland Drive, Dothan, AL 36301 2010-10-15
1588894976 Atwill Lamar Miller Jr. Urology 1908 Fairview Avenue, Dothan, AL 36301 2009-07-20
Find all providers in zip 36301

Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1295362408 Stephen M Pendergraft Nurse Practitioner 4740 W Main St, Dothan, AL 36305-9423 2020-03-26
1689205767 Sassy Lashawn Sylvester Nurse Practitioner 410 Ridgeland Rd, Dothan, AL 36301-1117 2020-01-28
1144732520 Kasey Duffie Chance Nurse Practitioner 211 Brushfire Dr, Dothan, AL 36305-7069 2017-10-25
1306364062 Janeetra Janiece Coachman Nurse Practitioner 9 Trillium Cir Apt 1401, Dothan, AL 36301-7653 2017-09-01
1265954010 Melanie Jo Ellison Nurse Practitioner 973 Dunn Rd, Dothan, AL 36303-1056 2017-07-13
1679012629 Elva Calderon Nurse Practitioner 1736 E Main St Ste 100, Dothan, AL 36301-3040 2017-02-22
1649610395 Kelli Saage Anderson Nurse Practitioner 1146 Ross Clark Cir, Dothan, AL 36301-3022 2013-06-26
1902040090 Cindy Ruth Hemendinger Nurse Practitioner 3124 Ross Clark Cir, Dothan, AL 36303-3038 2009-04-21
1770737249 Kelley E Blake Nurse Practitioner 4300 W Main St Ste 45, Dothan, AL 36305-1317 2008-11-11
1801494661 Ali Danielle Loflin Nurse Practitioner 4274 W Main St, Dothan, AL 36305-1062 2020-10-14
Find all providers in DOTHAN

Competitor

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City DOTHAN
Zip Code 36301

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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