Organization
EXECUTIVE UROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT W RICE MD (PRESIDENT)
(419) 627-8771
Entity
Organization
Contact information
Practice address
278 BENEDICT AVE, SUITE 650, NORWALK, OH 44857-2399
(419) 668-4328
Mailing address
2800 HAYES AVE, BLDG D, SANDUSKY, OH 44870-7248
(419) 627-8771
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2281972
—
OH
01
—
CG9157
RAILROAD MEDICARE
OH
Enumeration date
03/24/2010
Last updated
03/24/2010
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