Individual
NICKLAUS TRENT RICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2750 OWENS DR, CONYERS, GA 30094
(678) 413-4644
Mailing address
2750 OWENS RD SW, CONYERS, GA 30094-3991
(678) 413-4644
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
GA72427
GA
207VG0400X
Gynecology Physician
MD0000046779
TN
Other
Enumeration date
04/04/2011
Last updated
11/13/2019
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