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Individual
TICE ASHURST
Active
Individual
TICE ASHURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
02004412A
IN
207P00000X
Emergency Medicine Physician
Primary
OT014277
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0118784
—
OH
Enumeration date
06/03/2011
Last updated
10/30/2025
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