Individual
EDWARD E KICE III
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1700 E 19TH ST, THE DALLES, OR 97058-3317
(541) 298-7936
(541) 296-7619
Mailing address
PO BOX 1044, THE DALLES, OR 97058-9044
(541) 298-7936
(541) 296-7619
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD18439
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457605
—
WA
Enumeration date
03/09/2006
Last updated
07/08/2007
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